New Technique: Paravertebral Muscle Refashioning in Meningiomyelocele Repair

Abstract
Background: One of the most complications of meningi-omyelocele surgical repair is early postoperative Cerebrospinal fluid (CSF) leakage. Cystic back swelling due to prolonged sitting of children is an annoying symptom of their parents.
Aim of the Study: To assess the technique of paravertebral muscle refashioning in meningiomyelocele repair as a protec-tive layer of opened spinal canal.
Study Design: A prospective clinical trial study of 46 infants, 25 boys and 21 girls, with meningiomyelocele which was repaired surgically using paravertebral muscle refashioning technique in 18 infants (group I) while 28 infants without this technique (group II) at Benha University and Benha children Hospitals through the period from May 2013 to April 2017. The mean period of follow-up was (18.27±2.78 months).
Patients and Methods: Comparison was performed be-tween two groups by analysis of early postoperative CSF subcutaneous swelling and late pulsatile cystic swelling of repaired defect.
Results: Forty six infants were studied, 25 boys (54.3%) and 21 girls (45.7%) with mean age 29.7±15.39 days (ranging from 1 to 90 days), and they were followed up with a mean of 18.27±2.78 months (ranging from 12 to 24 months). Early postoperative CSF leakage was absent in 72.8% of group I and 71.4% of group II which was statistically non significant between two techniques while late cystic back swelling was not detected in 88.9% of group I and only 32.1% of group II which was statistically significant (p<0.001).
Conclusion: Paravertebral muscle refashioning in menin-giomyelocele repair is an effective technique for prevention of late cystic back swelling.