Myelomenigocele Kyphectomy: Review of the Effects of Cordotomy on Urodynamics

The purpose of this study is to review the urologic sequelae of cordotomy in the performance of kyphectomy in patients with myelomeningocele. Bladder function was assessed clinically and quantitatively with urodynamics pre- and post-operatively in 12 children who underwent this procedure at our institution between 1992 and 2000. Mean age of the patients at the time of surgery was 12.6 years and mean follow-up was 5.2 years (1.3 –10.2 years). Mean kyphosis measured 110 degrees (75- 160 degrees), 15 degrees (0-55 degrees), and 20 degrees pre-operatively, post-operatively, and at most recent follow-up, respectively. Postoperatively, 10 patients had no significant change in urologic function; one patient had significant improvement in bladder function including increased capacity and compliance; and one had deterioration in bladder function requiring surgical intervention. We conclude that cordotomy can be performed in the correction of myelomeningocele kyphosis without adverse urologic sequelae.