The evolution of surgical treatment of spinal deformity in myelomeningocele.

Although modern anterior and posterior fusion techniques can provide excellent correction of dysraphic spinal deformities, the surgery can be formidable. Newer surgical techniques utilizing segmental spinal fixation of implants has afforded both a greater degree of three-dimensional correction of spinal deformity and more rigid control of the fusion mass. However, due to the inherent loss of posterior elements and the associated high level of paralysis, the use of bivalved total contact spinal orthoses are essential to achieving a high fusion rate with a minimum number of complications.