alexa Primary Repair of a Myelomeningocele in a Geriatric Patient: A Case Report | OMICS International | Abstract
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Primary Repair of a Myelomeningocele in a Geriatric Patient: A Case Report

Ryan P Morton1*, Tanya Z Filardi1 and Trent L Tredway2
1Department of Neurological Surgery, Box 359766, Harborview Medical Center, 325 9th Avenue, Seattle, WA 98104, USA
2Department of Neurological Surgery, Box 356470, University of Washington, 1959 NE Pacific St., Seattle, WA 98195-6470, USA
Corresponding Author : Ryan P Morton
Department of Neurological Surgery
Box 359766, Harborview Medical Center
325 9th Avenue Seattle, WA 98104, USA
E-mail: [email protected]
Received July 18, 2013; Accepted August 23, 2013; Published August 26, 2013
Citation: Morton RP, Filardi TZ, Tredway TL (2013) Primary Repair of a Myelomeningocele in a Geriatric Patient: A Case Report. J Clin Case Rep 3:294. doi:10.4172/2165-7920.1000294
Copyright: © 2013 Morton RP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Myelomeningocele is the most common open spinal dysraphism eligible for surgical repair. Traditionally, myelomeningocele patients that received no surgical intervention had a dismal prognosis. Before 1970, 80% of untreated infants were dead at 3 months, while after 1970 more untreated children survived infancy but usually did not live past adolescence. Adult presentation of myelomeningocele is exceedingly rare. Case presentation: We present a 74 years Caucasian female was transferred to our institution for evaluation of purulent drainage around an unrepaired myelomeningocele site. Per the patients report, she was offered no surgical treatment for her myelomeningocele as a newborn, but was instead treated with percutaneous needle drainage of the lumbar fluid collection on a weekly basis for several months. Examination of her back was notable for a large 6 cm×6 cm fluid filled mass in the lumbosacral region with an abnormal epithelialized covering and purulent drainage. Her brain MRI revealed arrested hydrocephalus and a Chiari II malformation. Due to the infection, she underwent surgical correction of the myelomeningocele. At 6 month follow up she had a well healed wound and no complications from the surgery. Conclusion: The present case adds to the small body of literature describing adult presentation of spinal dysraphism. To our knowledge, this is the oldest patient to undergo primary repair of a congenital myelomeningocele. Primary repair, even in the elderly, is possible and can be done safely.

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