63700 Repair of meningocele; less than 5 cm diameter

Name of the Procedure:

Repair of Meningocele (less than 5 cm diameter)

• Common Name(s): Meningocele Repair
• Technical/Medical Term: Meningocele Reconstruction

Summary

Meningocele repair is a surgical procedure to correct a small meningocele, a type of spinal defect where the protective membranes around the spinal cord protrude through an opening in the vertebrae. This procedure helps to enclose the exposed membranes to protect the spinal cord and prevent potential complications.

Purpose

• Medical Condition: Meningocele, a form of spina bifida.
• Goals: To cover and secure the exposed membranes, prevent infections, and protect the spinal cord.

Indications

• Symptoms: Visible sac-like protrusion on the spine, potential risk of infection or nerve damage.
• Patient Criteria: Typically infants diagnosed with meningocele less than 5 cm in diameter, confirmed through prenatal or postnatal imaging.

Preparation

• Pre-Procedure Instructions: The patient (or the parents, if it's an infant) may need to follow specific fasting guidelines before surgery. Medication adjustments may be necessary, and certain medications might be temporarily discontinued.
• Diagnostic Tests: Imaging studies such as MRI or ultrasound to evaluate the size and specifics of the meningocele.

Procedure Description

1. Step-by-Step Explanation:
   • The patient is placed under general anesthesia.
   • An incision is made around the meningocele.
   • The protruding membranes are carefully repositioned or removed.
   • The opening in the vertebrae is closed using sutures or a graft, if necessary.
   • The incision is then closed with sutures or surgical staples.
2. Tools and Equipment: Scalpels, sutures, graft material (if needed), surgical drapes.
3. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.

Duration

The procedure typically takes about 2 to 3 hours.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Healthcare Professionals: Pediatric neurosurgeon, anesthesiologist, surgical nurses, and possibly a pediatrician for post-operative care.

Risks and Complications

• Common Risks: Bleeding, infection, cerebrospinal fluid leakage.
• Rare Complications: Nerve damage, spinal cord injury, complications from anesthesia.
• Management: Monitoring for signs of infection, appropriate post-operative care, and follow-up imaging if necessary.

Benefits

• Expected Benefits: Protection of the spinal cord, reduced risk of infections and complications, improved overall quality of life.
• Realization of Benefits: Typically noticeable immediately after recovery but may include long-term monitoring.

Recovery

• Post-Procedure Care: The patient will need to stay in the hospital for a few days for monitoring. Pain management will be provided.
• Recovery Time: Full recovery can take several weeks, with activity restrictions in place to allow for proper healing.
• Follow-Up: Regular follow-up appointments to monitor healing and development.

Alternatives

• Other Treatment Options: Observation for very small, asymptomatic meningoceles; nonsurgical management if surgery poses high risk.
• Pros and Cons: Surgery is generally recommended to prevent complications, while nonsurgical management carries the risk of future issues.

Patient Experience

• During Procedure: The patient will be under general anesthesia and unconscious.
• After Procedure: Post-operative pain is managed with medications. The patient may experience discomfort around the incision site, which should improve within a few days. Regular monitoring and follow-up care will be essential.