For twenty-three children with myelomeningocele, three types of
operations, all including vertebral-body excision, were done to decrease
and stabilize the kyphosis: (1) excision of the apical vertebra and a
portion of the neighboring vertebra was done in five patients; (2) excision
of the apical vertebra and of one or more vertebrae on each side of it, in
eight patients; and (3) partial resection of the apical vertebra and of the
proximal lordotic curve, in twelve patients. Loss of correction and
increase of the kyphotic prominence equal to or greater than preoperative
levels were encountered after the first two operations. The third operation
provided persistent correction and the remaining lumbar vertebrae then
continued to grow, increasing the capacity of the abdominal cavity.