Operative repair of lumbosacral myelomeningocele. Technical note.

A technique is described for closure of lumbosacral myelomeningoceles. The pathological anatomy of these lesions is examined, and the junction of the skin and dura is identified as the "junctional zone." This zone permits maximal preservation of the available dura for watertight closure after operative dissection. The junctional zone also serves as an anchor for traction sutures, permitting skin closure without tension. Seventy consecutive repairs have been completed by the authors without significant complications. There have been no instances of cerebrospinal fluid leaks, meningitis, or wound dehiscence. In all cases the repair was carried out rapidly and in a single stage.