Tissue expansion facilitates operation of large myelomeningoceles.

Two children had delayed operations for large myelomeningoceles. As a preparatory operation one silicon tissue expander was inserted on each side of the lesion and successively inflated by weekly injections of saline. After an expansion time of 5 to 6 weeks the definitive procedure was performed. The newly formed fibrous capsule greatly facilitated the reconstruction of the spinal canal. The surplus of skin and subcutaneous tissue allowed the large defects to be easily close in the midline. Both children managed quite well postoperatively.