Affected children will require treatment from a multidisciplinary team to address any associated physical, developmental, hearing, and visual and learning difficulties that may occur in association with the NTD.
The newborn with an open NTD should be kept warm and the defect covered with a sterile saline dressing.
The baby should be positioned in the prone position to prevent pressure on the defect.
Open NTDs should be closed promptly.
Hydrocephalus: ventriculoperitoneal shunt placed at the time of myelomeningocele closure.
Symptomatic Chiari malformations: suboccipital craniotomy and decompression of the posterior fossa and tonsils.
Syrinx (a fluid-filled cavity within the spinal cord or brainstem): laminectomy and placement of a syringosubarachnoid stent to divert the CSF out of the central canal.
In utero surgical repair has been practised in several centres in the USA for many years. The Management of Myelomeningocele Study (MOMS) has now evaluated this in a controlled trial and shown short-term benefits for the newborn, including 50% reduction in the need for hydrocephalus shunting and significant improvement in spinal neurological function.