Early repair of myelomeningocele and simultaneous insertion of ventriculoperitoneal shunt: technique and results.

During the years 1975 to 1985, 10 patients underwent simultaneous repair of myelomeningocele and insertion of a ventriculoperitoneal shunt at the Hospital for Sick Children in Toronto. The technique for carrying out these procedures in the same operative setting will be described. None of the patients developed shunt infections or myelomeningocele repair breakdown in the follow-up period of 1 to 9 years. One patient died 9 days after operation secondary to aspiration. The remaining patients underwent neuropsychological testing during their follow-up periods and over 70% were found to have normal or slightly below normal intelligence and psychosocial development. The technique of simultaneous repair of a myelomeningocele and insertion of a ventriculoperitoneal shunt in infants with a myelomeningocele and concomitant hydrocephalus overt at birth is safe and should be carried out to decrease the risk of myelomeningocele repair breakdown and cerebrospinal fluid leak in such patients.