Repair of lumbosacral myelomeningoceles with double Z-rhomboid flaps

The authors describe a double Z-rhomboid technique for the closure of large lumbosacral myelomeningocele defects. After the dorsally displaced neural tissue has been reduced into the vertebral canal and a watertight closure of the dura lining the sac has been achieved, the skin defect is surgically converted to the shape of a rhombus. Equilateral Z-plasty flaps are elevated at the sides of the rhombus and transposed across the defect to secure wound closure. A successful experience with 10 consecutive cases of lumbosacral myelomeningoceles repaired with this technique is reported.