Child's Nervous System

, Volume 35, Issue 4, pp 673–681 | Cite as

Kyphectomy in neonates with meningomyelocele

  • Nail ÖzdemirEmail author
  • Senem Alkan Özdemir
  • Esra Arun Özer
Original Paper



Kyphosis is the most severe spinal deformity associated with meningomyelocele (MMC) and is seen in approximately 15% of neonates. Our purpose is to present our clinical experience, to discuss the technique and deformity correction in kyphectomy in neonates with MMC, and to assess its long-term outcomes.


In this prospective study, the authors reviewed eight cases submitted to surgery between 2013 and 2015. We evaluated clinical characteristics that were analyzed, as were the operative technique employed, and angle range of the kyphosis deformity postcorrection follow-up.


Neonatal kyphectomy was performed of six females and two males. The mean birth weight was 2780 g, and the mean age at the time of surgery was 5.6 days. There were S-shaped type deformity in lumbar region in all neonates. In the correction of the kyphotic deformity, a total vertebrae were removed from four patient, whereas a partial vertebrectomy was done in four. The mean operative time was 116 min. No patients did not require the blood transfusion. There were no serious complications, and wound closure was successful in all patients. The mean follow-up period was 4 years and 3 months (range 36–61 months), except one patient who died 1 week after discharge. The mean preoperative kyphosis of 75.6° (range, 50°-90°) improved at last follow-up to 35° (range 15°–55°). All patients had surgical procedures for hydrocephalus. Three patients had surgery for Chiari type II malformation. The mean hospital stay was 27.7 days.


Kyphectomy performed at the time of dural sac closure in the neonate is a safe procedure with excellent correction.


Kyphectomy Meningomyelocele Neonate Neural tube defects Newborn 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. 1.
    Banta JV, Hamada JS (1976) Natural history of the kyphotic deformity in myelomeningocele. J Bone Joint Surg Am 58:279CrossRefGoogle Scholar
  2. 2.
    Bartonek A, Saraste H (2001) Factors influencing ambulation in myelomeningocele: a cross-sectional study. Dev Med Child Neurol 43:353–260CrossRefGoogle Scholar
  3. 3.
    Christofersen MR, Brooks AL (1985) Excision and wire fixation of rigid myelomeningocele kyphosis. J Pediatr Orthop 5:691–696CrossRefGoogle Scholar
  4. 4.
    Crawford AH, Strub WM, Lewis R, Gabriel KR, Billmire DA, Berger T, Crone K (2003) Neonatal kyphectomy in the patient with myelomeningocele. Spine 28:260–266Google Scholar
  5. 5.
    Doers T, Walker JL, van den Brink KD, Stevens DB, Heavilon J (1997) The progression of untreated lumbar kyphosis and compensatory thoracic lordosis in myelomeningocele. Dev Med Child Neurol 39:326–330Google Scholar
  6. 6.
    Duddy JC, Caird J, Connolly P (2013) Repair of a large thoracolumbar myelomeningocele with associated lumbar kyphosis. Acta Neurochir 155:1965–1968CrossRefGoogle Scholar
  7. 7.
    Eckstein HB, Vora RM (1972) Spinal osteotomy for severe kyphosis in children with myelomeningocele. J Bone Joint Surg Br 54:328–333CrossRefGoogle Scholar
  8. 8.
    Gepp RA, Quiroga MRS, Gomes CR, Araujo HJ (2013) Kyphectomy in meningomyelocele children: surgical technique, risk analysis, and improvement of kyphosis. Child Nerv Syst 29:1137–1141CrossRefGoogle Scholar
  9. 9.
    Guille JT, Sarwark JF, Sherk HH, Kumar SJ (2006) Congenital and developmental deformities of the spine in children with meningomyelocele. J Am Acad Orthop Surg 14:294–302CrossRefGoogle Scholar
  10. 10.
    Karlin MI (2007) Kyphectomy for myelodysplasia. Neurosurg Clin N Am 18:357–364CrossRefGoogle Scholar
  11. 11.
    Lindseth RE, Stelzer L (1979) Vertebral excision for kyphosis in children with myelomeningocele. J Bone Joint Surg Am 61:699–704CrossRefGoogle Scholar
  12. 12.
    Martin J, Kimar SJ, Guille JT, Ger D, Gibbs M (1994) Congenital kyphosis in myelomeningocele: results following operative and nonoperative treatment. J Pediatr Orthop 14:323–328CrossRefGoogle Scholar
  13. 13.
    Lindseth RE (1991) Spine deformity in myelomeningocele. Instr Course Lec 40:273–286Google Scholar
  14. 14.
    Linther SA, Lindseth RE (1994) Kyphotic deformity in patients who have a myelomeningocele. J Bone Joint Surg Am 76:1302–1307Google Scholar
  15. 15.
    Lowe GP, Menelaus MB (1978) The surgical management of kyphosis in older children with myelomeningocele. J Bone Joint Surg Br 60:40–45CrossRefGoogle Scholar
  16. 16.
    Marreiros H, Loff C, Calado E (2015) Who needs surgery for pediatric myelomeningocele? A retrospective study and literature review. J Spinal Cord Med 38:626–640CrossRefGoogle Scholar
  17. 17.
    Mintz LJ, Sarwark JF, Dias LS, Schafer MF (1991) The natural history of congenital kyphosis in myelomeningocele: a review of 51 children. Spine 16:S348–S350CrossRefGoogle Scholar
  18. 18.
    Sharrard WJW (1968) Spinal osteotomy for congenital kyphosis in myelomeningocele. J Bone Joint Surg Br 50:466–471CrossRefGoogle Scholar
  19. 19.
    Sharrard WJW, Drennan JC (1972) Osteotomy-excision of the spine for lumbar kyphosis in older children with myelomeningocele. J Bone Joint Surg Br 54:50–60CrossRefGoogle Scholar
  20. 20.
    Yoshioka K, Watanabe K, Toyama Y, Chiba K, Matsumoto M (2011) Kypectomy for severe kyphosis with pyogenic spondylitis associated with myelomeningocele: a case report. Scoliosis 6:5CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Tepecik Research and Education Hospital, Deparment of NeurosurgeryHealth Sciences UniversityİzmirTurkey
  2. 2.Behçet Uz Children’s Hospital, Department of NeonatologyHealth Sciences UniversityİzmirTurkey
  3. 3.School of Medicine, Department of NeonatologyCelal Bayar UniversityManisaTurkey

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