This 2006 narrative review by Guille et al. synthesizes the natural history, evaluation framework, and surgical management of spinal deformities in children with myelomeningocele, focusing specifically on the two most clinically challenging problems: paralytic scoliosis and rigid lumbar kyphosis. It does not present original outcome data but consolidates evidence to guide treatment decision-making in a medically complex population.
When you see a child with myelomeningocele and a thoracic motor level, assume significant scoliosis risk and begin surveillance early — motor level, ambulatory status, and last intact laminar arch are your three key predictors.
Before any spinal surgery in this population, check a urine culture, confirm shunt function, address latex precautions, and counsel the family that complication rates are high even with meticulous technique.
This 2006 narrative review by Guille et al. synthesizes the natural history, evaluation framework, and surgical management of spinal deformities in children with myelomeningocele, focusing specifically on the two most clinically challenging problems: paralytic scoliosis and rigid lumbar kyphosis. It does not present original outcome data but consolidates evidence to guide treatment decision-making in a medically complex population.
When you see a child with myelomeningocele and a thoracic motor level, assume significant scoliosis risk and begin surveillance early — motor level, ambulatory status, and last intact laminar arch are your three key predictors.
Before any spinal surgery in this population, check a urine culture, confirm shunt function, address latex precautions, and counsel the family that complication rates are high even with meticulous technique.