Principles and experience of surgical treatment of spina bifida in adults

Abstract

The study objective was to summarize our own experience of surgical treatment of spina bifida in adults. The mean age of patients was 33 years. The time elapsed since the onset of clinical presentations till surgery varied from 11 to 14 years. Among all elective, surgically significant pathologies of the spinal cord (tumors, syringomyelia, arachnoid cysts, spontaneous epidural hematoma, epidural abscess, abscess), spina bifida in adults amounted to 5.9%. The level of social adaptation of patients at the time of diagnosis was quite acceptable (patients had a normal index of intellectual development and the ability to move). The amount of surgery was large and included implementation of several important surgical manipulations. The operative time was 5.5 h, on average. As a result, the spinal cord and its roots were released from compression and retaining structures that, to some extent, allowed for avoiding dissection of the terminal ligament. Minimally invasive technologies can not still ensure implementation of all surgical manipulations for correction of the vertebral-medullary anomaly. Surgical treatment of congenital anomalies of the spinal cord in adults proved to be reasonable and effective.