• Joseph C Watson, Gary Tye, and John D Ward.
• Harold F. Young Neurosurgical Center, Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, USA. Electronic address: jwatson4@vcu.edu.
• World Neurosurg. 2014 Feb 1;81(2):428-30.

ObjectiveMyelomeningocele is a defect that typically is repaired surgically within the first few days of life in developed countries to minimize the risk of meningitis. If left unrepaired, these children may survive to have their meningocele sac epithelialize. The surgical reduction and closure of an epithelialized myelomeningocele represents a unique challenge for the neurosurgeon because it requires a modification of the typical closure technique.MethodsOur 10 years' experience in 97 patients with the delayed (>6 months) repair of myelomeningoceles formed the basis of this report.ResultsWe present repair techniques in a child with a myelomeningocele that was not repaired at birth and presented a surgical challenge.ConclusionDelayed closure of myelomeningoceles is facilitated by lessons learned from our surgical experience during a medical missions to Guatemala.Copyright © 2014 Elsevier Inc. All rights reserved.

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