Luigino Santecchia
Study background: The authors present a case of a giant thoracolumbar myelomenigocele (T9-L5) in a newborn of 39 weeks. The goal of the procedure is to provide an amount of adequate cutaneous subcutaneous tissue, which allows an efficient coverage of the duraplasty, and reduces the risk of infections and the tissue stretching at the same time. Methods: Closure of the defect was achieved using a patch of fascia lata and soft tissues were reconstructed using latissimus dorsi muscolar flap and a split thickness skin graft. Primary correction was performed immediately after birth, as a neurosurgical emergency. Few days after surgery, a complete dehiescence of the suture occurred. Result: We outline here a favourable outcome of a giant MMC bursting primar repair, using the LDMF. Follow-up is now at 2 years and local conditions are excellent. Conclusion: The use of Latissimus Dorsi Flap could be considered the first choicefor treatment of giant myelomenigocele in newborn. It gives a higher chance of getting immediately the definitive and qualitatively better repair of the defect with reduced risk of local and systemic complications.
