Myelomeningocele Surgery Before and After

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Myelomeningocele is a severe form of spina bifida, a birth defect where the baby’s spinal cord and meninges (protective layers of the spinal cord) protrude through an opening in the spine. This condition requires early surgical repair to protect the spinal cord from damage, infection, and further complications.

Surgical intervention by the neurosurgeon aims to close the defect and preserve nerve function.  The plastic surgeon aims to cover the exposed tissues using either primary closure or flap reconstruction techniques, depending on the size and location of the lesion.

• Newborns diagnosed with myelomeningocele (an open form of spina bifida) where the spinal cord and nerves protrude through the back.

• Infants at risk of infection or injury to the exposed spinal tissues if not surgically closed early.

• Patients with leakage of cerebrospinal fluid from the defect.

Before surgery: Before myelomeningocele surgery, the baby is carefully evaluated and stabilized, including checking breathing, hydration, and overall condition. The exposed spinal area is kept clean, moist, and protected with sterile dressings to prevent infection and injury. The neurosurgeon and plastic surgeon work closely to assess the defect and plan the repair. 

Anesthesia: general anesthesia

Incision: the neurosurgeon first gently places the exposed spinal cord and nerves back into the spinal canal and closes the protective layers around it. After this, the plastic surgeon helps close the overlying skin defect by carefully mobilizing and stitching surrounding skin or using specialized reconstruction techniques if there is not enough skin to cover the area. This teamwork protects the spinal cord, reduces infection risk, and allows the back to heal as safely and completely as possible.

Procedure Time:  3-5 hours depending on severity

• Post-op Course: the baby is closely monitored in the hospital for several days to ensure the wound is healing well and there are no signs of infection or fluid leakage. The baby is usually kept lying in a special position (often on the side or stomach) to avoid pressure on the surgical site, and feeding and movement are carefully managed.

• Suture Removal: sutures are removed after 14 days
   
• Downtime: the baby is closely monitored for a period of 2-4 weeks

• Scarring:  scars are usually visible for 1-3 months and will gradually fade over 6-12 months
   
• Results: After myelomeningocele surgery, the main goal is to safely close the spinal defect, protect the exposed nerves, and reduce the risk of infection. While the surgery does not reverse existing nerve damage, it helps preserve remaining function and supports safer long-term growth and development.

Q: Is surgery a cure for spina bifida?
A: No — surgery repairs the spinal defect and helps prevent further damage, but long-term care is needed for mobility, bladder, bowel, and neurological management.

Q: Will my child walk normally after surgery?
A: It depends on the level of the spinal lesion. Some children may walk with assistance or independently, while others may require mobility aids.

Q: Can myelomeningocele return after surgery?
A: Once repaired, the defect does not recur. However, ongoing monitoring is needed for hydrocephalus, tethered cord, and orthopedic concerns.

Q: What happens if surgery is delayed?
A: Delays increase the risk of infection, neurological damage, and poor healing outcomes. Early surgical repair is strongly recommended.

Dr. Aicee Bernal is a board-certified plastic and reconstructive surgeon with extensive experience in pediatric reconstructive procedures. She collaborates closely with neurosurgeons and pediatricians to provide safe, well-coordinated care for newborns and infants with neural tube defects like myelomeningocele.

If your baby has been diagnosed with myelomeningocele, don’t face it alone.
Schedule a consultation with Dr. Aicee Bernal, and ensure your child receives expert, compassionate care from a trusted pediatric reconstructive surgeon.