Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Pediatric Myelomeningocele

Executive Summary

Catherine A. Mazzola, Nadege Assassi, Lissa C. Baird, David F. Bauer, Alexandra D. Beier, Jeffrey P. Blount, Susan R. Durham, Ann Marie Flannery, Paul Klimo, Catherine McClung-Smith, Dimitrios C. Nikas, Patricia Rehring, Mandeep S. Tamber, Rachana Tyagi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: The incidence of spina bifida (SB) in the developing world is higher than in the United States because of malnutrition and folic acid deficiency during pregnancy. Advances in technology have made prenatal repair of myelomeningocele (MM) possible. OBJECTIVE: The objective of the guidelines are, (1) To create clinical recommendations for best practices, based on a systematic review and analysis of available literature, (2) to obtain multi-disciplinary endorsement of these guidelines from relevant organizations, and (3) to disseminate the educational content to physicians to improve the care of infants with MM. METHODS: The Guidelines Task Force developed search terms and strategies used to search PubMed and Embase for literature published between 1966 and September 2016. Strict inclusion/exclusion criteria were used to screen abstracts and to develop a list of relevant articles for full-Text review. RESULTS: Guidelines authors aimed to systematically review the literature and make evidence based recommendations about the timing of closure after birth, hydrocephalus, the impact of prenatal closure, and the effect of prenatal closure on ambulation ability and tethered spinal cord. Evidence concerning persistent ventriculomegaly and cognitive impairment was also evaluated. Hundreds of abstracts were identified and reviewed for each of the 5 topics. A total of 14 studies met stringent inclusion criteria. CONCLUSION: Based on a comprehensive systematic review, a total of 5 clinical practice recommendations were developed, with 1 Level I, 2 Level II and 2 Level III recommendations. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-1.

Original languageEnglish (US)
Article numbernyz261
Pages (from-to)299-301
Number of pages3
JournalClinical Neurosurgery
Volume85
Issue number3
DOIs
StatePublished - Sep 1 2019

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Meningomyelocele
Spinal Dysraphism
Neural Tube Defects
Guidelines
Pediatrics
Folic Acid Deficiency
Infant Care
Aptitude
Advisory Committees
Hydrocephalus
Practice Guidelines
PubMed
Malnutrition
Walking
Spinal Cord
Parturition
Organizations
Technology
Physicians
Pregnancy

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Mazzola, C. A., Assassi, N., Baird, L. C., Bauer, D. F., Beier, A. D., Blount, J. P., ... Tyagi, R. (2019). Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Pediatric Myelomeningocele: Executive Summary. Clinical Neurosurgery, 85(3), 299-301. [nyz261]. https://doi.org/10.1093/neuros/nyz261

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Pediatric Myelomeningocele : Executive Summary. / Mazzola, Catherine A.; Assassi, Nadege; Baird, Lissa C.; Bauer, David F.; Beier, Alexandra D.; Blount, Jeffrey P.; Durham, Susan R.; Flannery, Ann Marie; Klimo, Paul; McClung-Smith, Catherine; Nikas, Dimitrios C.; Rehring, Patricia; Tamber, Mandeep S.; Tyagi, Rachana.

In: Clinical Neurosurgery, Vol. 85, No. 3, nyz261, 01.09.2019, p. 299-301.

Research output: Contribution to journalArticle

Mazzola, CA, Assassi, N, Baird, LC, Bauer, DF, Beier, AD, Blount, JP, Durham, SR, Flannery, AM, Klimo, P, McClung-Smith, C, Nikas, DC, Rehring, P, Tamber, MS & Tyagi, R 2019, 'Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Pediatric Myelomeningocele: Executive Summary', Clinical Neurosurgery, vol. 85, no. 3, nyz261, pp. 299-301. https://doi.org/10.1093/neuros/nyz261
Mazzola, Catherine A. ; Assassi, Nadege ; Baird, Lissa C. ; Bauer, David F. ; Beier, Alexandra D. ; Blount, Jeffrey P. ; Durham, Susan R. ; Flannery, Ann Marie ; Klimo, Paul ; McClung-Smith, Catherine ; Nikas, Dimitrios C. ; Rehring, Patricia ; Tamber, Mandeep S. ; Tyagi, Rachana. / Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for Pediatric Myelomeningocele : Executive Summary. In: Clinical Neurosurgery. 2019 ; Vol. 85, No. 3. pp. 299-301.
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AU - Klimo, Paul

AU - McClung-Smith, Catherine

AU - Nikas, Dimitrios C.

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