ABSTRACT
The surgical management of spinal deformities in children with myelomeningocele is a challenge for the surgeon due to the unique pathological features of the spinal deformity. Myelomeningocele patients experience an increased number of complications when compared to patients with idiopathic scoliosis. Occurence of complications such as deep wound infections, pseudarthrosis, skin ulcers, hardware failure, and urinary tract infection has been reported to range from 7.5% to as high as 61% of operative cases (1-3). Some of the features that separate these patients from others include dysraphic malformations of the posterior spinal elements, upper spinal cord anomalies leading to hydrocephalus, paralysis with asymmetry, and earlier onset of spinal deformities (4). These features must all be taken in consideration when treating spinal deformities in myelomeningocele patients. The overall complication rates in the past decade have decreased due to more stable implant constructs, multi-staged surgery in one anesthetic session, and multispecialty care.
