Orthopedic management of myelomeningocele with a multidisciplinary approach: a systematic review of the literature

Journal of Orthopaedic Surgery and Research

Mohammad Hossein Nabian¹  Fardis Vosoughi¹  Ana Presedo²  Amirali Karimi³  Sara Momtazmanesh⁴  Parnian Shobeiri⁵ 

[1] Department of Orthopedic and trauma surgery, Shariati Hospital and School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran;Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences (TUMS), Tehran, Iran;Department of Pediatric Orthopedics, Hôpital Robert Debre, Paris, France;School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran;School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran;Universal Scientific Education and Research Network (USERN), Tehran, Iran;School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran;Universal Scientific Education and Research Network (USERN), Tehran, Iran;Non–Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran;

关键词: Interdisciplinary;    Communication;    Meningomyelocele;    Orthopedics;    Spinal dysraphism;   

DOI  :  10.1186/s13018-021-02643-8

来源: Springer

【 摘 要 】

BackgroundMyelomeningocele (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.MethodsWe 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.ResultsTwenty-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.ConclusionOrthopedic 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

【 授权许可】

CC BY