Rotation flap closure of a giant dorsolumbar myelomeningocele: technical note

• Published in: Child's nervous system Vol. 37; no. 4; pp. 1323 - 1326
• Main Authors: Gomar-Alba, Mario, Vargas-López, Antonio José, Narro-Donate, José María, Castelló-Ruiz, María José, García-Pérez, Fernando, Masegosa-González, José
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2021
• Subjects: Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Technical Note; Rotation flap; O-S flap; Myocutaneous flap; Myelomeningocele (mmc)
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-020-05021-7

Purpose
Myelomeningocele (MMC) is the most prevalent form of spina bifida aperta. Here we present the surgical repair technique of a dorsolumbar myelomeningocele with a large associated soft tissue defect.
Methods
Data concerning the anamnesis and complementary studies were obtained from the clinical history. Surgical images were obtained in the operation room during surgery.
Result
We describe the case of a newborn with a dorsal myelomeningocele with a placode in the central area and a large associated skin defect of 12 x× 12 cm. Urgent intervention was carried out on the day of birth with placode reconstruction. Dorsal and gluteus maximus muscle rotation and skin rotation flap were performed in order to achieve complete closure of the myocutaneous defect. The patient presented a good recovery with no new neurological deficit.
Conclusion
Myelomeningocele may be associated with large myocutaneous defects that can be difficult to correct by primary closure. In these cases, rotation flaps may be necessary to achieve complete closure.