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Orthopedic Management of Myelomeningocele With a Multidisciplinary Approach: A Systematic Review of the Literature Publisher Pubmed



Shobeiri P1, 2, 3 ; Presedo A4 ; Karimi A1 ; Momtazmanesh S1, 2 ; Vosoughi F5, 6 ; Nabian MH5, 6
Authors
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Authors Affiliations
  1. 1. School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  2. 2. Universal Scientific Education and Research Network (USERN), Tehran, Iran
  3. 3. Non–Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Pediatric Orthopedics, Hopital Robert Debre, Paris, France
  5. 5. Department of Orthopedic and trauma surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  6. 6. Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences (TUMS), Tehran, Iran

Source: Journal of Orthopaedic Surgery and Research Published:2021


Abstract

Background: Myelomeningocele (MMC) is the most common and severe form of spina bifida and imposes a significant burden on patients and the healthcare system. Recently, the multidisciplinary management of MMC has become popular. Herein, we aimed to review the orthopedic management, outcomes, and complications of the of patients with MMC eyeing a multidisciplinary approach. Methods: We searched PubMed and EMBASE to find relevant studies published before August 2020. All studies that included clinical management of MMC patients and published earlier than 2000 were considered for review on the condition that they reported at least one orthopedic intervention and the rate of complications. We excluded review articles, case reports, case series, letters, commentaries, editorials, and conference abstracts. The primary and secondary goals of our review were to report the outcomes and complication rates of multidisciplinary management for MMC patients. Results: Twenty-six studies included data for the management of 229,791 patients with MMC and were selected. Sixteen studies reported multidisciplinary management in addition to orthopedic management. From those, 11 (42.31%) included urologic management, 13 (50%) neurosurgical management, 11 (42.31%) neurologic management, and 5 (19.23%) gastrointestinal management. All studies included postnatal operations and related management. No randomized clinical trial was found in our search. Conclusion: Orthopedic approaches play a key role in MMC management by alleviating spinal deformities, particularly scoliosis, and hip, foot, and ankle complications. However, the most appropriate management, whether surgical or non-surgical, may vary for different patients, given disease severity and the age of patients. Graphical abstract: [Figure not available: see fulltext.] © 2021, The Author(s).
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