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Myelomeningocele: the evolution of care over the last 50 years

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Abstract

Purpose

Myelomeningocele (MMC) is one of the representative anomalies in the field of pediatric neurosurgery. During the 50 years of ISPN history, MMC had a tremendous changes in its incidence, clinical management and outcome with advanced understanding of its pathogenesis. We reviewed the changes in MMC during the period.

Methods

We reviewed the literature review and collected our experiences.

Results

During the 50 years, major changes happened in many aspects of MMC including incidence, pathoembryogenesis, folate deficiency, prevention, prenatal diagnosis, mode of delivery, treatment policy with ethical considerations, clinical treatment including fetal surgery, latex allergy, retethering, management outcome, multidisciplinary team approach, and socioeconomic and family issues.

Conclusions

There was a great advance in the management and research of MMC during the 50 years. It is a monumental achievement of pediatric neurosurgeons and colleagues of the related fields.

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Acknowledgements

This work was supported by the National Research Foundation (NRF) funded by the Korean Government, the Ministry of Science and ICT (MSIT) (2018R1A5A2025964).

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Author notes

  1. Robin M. Bowman and Ji Yeoun Lee contributed equally.

Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children’s Hospital of Chicago; Neurosurgery Department, Northwestern University, Chicago, IL, USA

    Robin M. Bowman

  2. Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital, Seoul, Korea

    Ji Yeoun Lee & Kyung Hyun Kim

  3. Department of Anatomy and Cell Biology, Seoul National University College of Medicine, Seoul, Korea

    Ji Yeoun Lee

  4. Department of Neurosurgery, Myongji Hospital, Goyang, Korea

    Jeyul Yang

  5. Center for Rare Cancers, Neuro-oncology Clinic, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Kyounggi-do, 10408, Republic of Korea

    Kyu-Chang Wang

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Contributions

Robin Bowman discusses surgical treatment, including fetal surgery; Ji Yeoun Lee covers MMC as a secondary neurulation defect, fetal diagnosis, mode of delivery, management of sphincter problems, latex allergy, socioeconomic impact, and multidisciplinary clinics; Jeyul Yang focuses on folate deficiency, clinical problems, and surgery for associated anomalies of the CNS; Kyung Hyun Kim provides an introduction, epidemiology, mortality, and long-term outcomes; Kyu-Chang Wang discusses the pathogenesis. All authors read and approved the final manuscript.

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Correspondence to Kyu-Chang Wang.

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Bowman, R.M., Lee, J.Y., Yang, J. et al. Myelomeningocele: the evolution of care over the last 50 years. Childs Nerv Syst 39, 2829–2845 (2023). https://doi.org/10.1007/s00381-023-06057-1

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