gms | German Medical Science

Objective: The frequency of neurosurgical interventions in adults born with open myelomeningocele (MMC) is unknown. Transition from pediatric to adult care is often difficult due to a lack of adult interdisciplinary spina bifida centers. We have therefore analyzed the frequency and type of such interventions.

Methods: This is a retrospective single-center analysis of operations performed between 2010 and 2019 in patients ≥ 18 years of age with ICD-10-main diagnosis Q05.-, which is spina bifida. Patients with open MMC were selected and data collected from electronic records.

Results: We performed 20 operations in 13 patients (8 female, 5 male) with a mean age of 36 years (range 20 to 56), of which 6 patients had lumbar and 7 lumbosacral MMC. In 12 cases a detethering for tethered cord syndrome was performed, being symptomatic with pain (N=4), motor (N=6), sensory (N=2) or urological (N=4) deficits. In 7 cases shunt revisions were performed, being symptomatic with headache (N=5), papilledema (N=2) or abdominal pain (N=2). In one case an incidental cavernoma was removed.

Conclusion: 95% of operations performed in this cohort of adults patients born with open MMC were related to the primary disease: 60% were detetherings and 35% were shunt revisions. Neurological and urological symptoms were the presenting complaints. MMC-associated problems continue to occur in adulthood. The spectrum is similar to the pediatric age group and thus transition into interdisciplinary adult care should be achieved.