Many years ago, John Hilton1 pointed out the dangers of the current methods of treatment of "the disease called spina bifida." He found it safer to tap and bandage the protruding cystic sac than to inject or ligate it. Improvement in aseptic technic has lessened the immediate risk of surgical amputation, and further knowledge of the meningeal spaces makes one shudder at the thought of injecting iodine into these structures. But to judge from current literature, the results of treatment are not greatly improved over what they were in 1863, when Hilton warned the students of Guy's Hospital against the use of the knife.
The failures which have followed the procedure of amputation even in the most expert hands are due to the fact that in a large proportion of such cases the amputated sac had an important, sometimes an indispensable, function to serve. The operative method which we
PENFIELD W, CONE W. SPINA BIFIDA AND CRANIUM BIFIDUM: RESULTS OF PLASTIC REPAIR OF MENINGOCELE AND MYELOMENINGOCELE BY A NEW METHOD. JAMA. 1932;98(6):454–461. doi:10.1001/jama.1932.02730320014004
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