Cervical Meningomyelocoele: A Case Report and Review of the Literature

Abstract

Cervical meningomyelocoele is a rare neural tube defect accounting for 1-5% of all neural tube defects. Very few cases have been reported in literature. We present a 4day old female patient who presented with a cervical cystic lesion. There was no CSF leakage or sign of infection at presentation. On further evaluation, other congenital abnormalities were excluded by thorough clinical and radiological examination. The patient had normal movement in all four limbs pre-operatively. Intra-operatively, the CSF filled cystic lesion had a hollow fibro-neurovascular stalk extending through the vertebral defect at the level C2-C3. This stalk is thought to be non-functional in most cases in literature but because we could not establish functional status, the hollow stalk was repaired and buried in the surrounding tissue after dura repair. Intra-dural exploration was done to remove adhesions up to the level of the defect to reduce the risk of tethered spinal cord syndrome. Post-operatively, the patient had full power in all limbs with no CSF leak or surgical site infection.