Consideration of the Surgical Treatment for Myelomeningocele

Usually the surgical treatment of spina bifida cystica, especially the myelomeningocele and its significance are raising many controversies. Recently, in England, an early operation of the myelomeningocele (M.M.C.) is holding in period of 2 to 48 hours after birth and further active plastic operation of the M.M.C. is performing together with the atrio-ventricular shunt for combined hydrocephalus. Thus, the prevention of decrease of the intelligence and raise of survival rate were brought by this procedure. We have experienced 13 cases since this 3 years and we performed plastic operation of the M.M.C. in 10 cases among all cases. The shunt operation was combined in 7 cases of 10 cases and survival cases were 5 cases, that is, survival rate of 77%. An age of case was from one month to six years, their hydrocephalus was progressive considerably, and an intelligence was in low tendency. As an age of operation, our cases belong to so-called the late group. Now, so far as, we examine the late group of age for operation, we considered that the purpose of operation is to control the hydrocephalus, to prevent the rupture of the M.M.C. and then to remove an anxiaty of family for its phenomenon. We think, however, the counterplans for patient with handicaps of the paraplegia have been left behind in problems.