MYELOMENINGOCELE: THE IMPORTANCE OF A MULTIDISCIPLINARY APPROACH

Résumé

Purpose: The myelomeningocele (MM) is the most common congenital malformation of the central nervous system compatible with life, characterized by a failure of fusion of the posterior elements of the spinal cord associated with numerous complications, such as neurological, orthopedic and sphincter disorders. The scope of this article is to verify the regularity of the multidisciplinary follow-up of these patients and describe the main complications. Methods: A case series was carried from the consecutive review of patients (medical files) undergoing surgical correction of MM in a public pediatric referral hospital in northeastern Brazil, operated between September 2009 and September 2013. Results: In the period proposed for the study, 40 patients underwent surgical repair of the MM. There was a slight male predominance (53%), and 65% of patients came from the countryside area. In 68% was observed outpatient treatment regularly (multidisciplinary follow-up). Regarding neurological, orthopedic and sphincter deficits, there was a predominance of hydrocephalus (85%), followed by clubfoot (70%) and neurogenic bladder (65%). Conclusions: Multidisciplinary follow-up in patients undergoing MM repair in a public referral hospital in northeastern Brazil is lagging behind. Despite high rates of neurological deficits, orthopedic and sphincter disorders, there is a great difficulty in treatment adherence and multidisciplinary follow-up in this group evaluated.