AORTOGRAPHIC FINDINGS IN CHILDREN WITH MY ELOMENINGOCELE AND LUMBAR-KYPHOSIS

The findings in abdominal aortographies performed preoperatively in 21 children with myelomeningocele (MMC), which underwent kyphectomy due to congential kyphosis of the lumbar spine, are reported. In no case d id the aorta follow the kyphotic radius of curvature. It rather seemed to be strung over the kyphosis like a tendon over a bow. An intraoper ative lesion of the aorta seems rather unlikely, and this is why we be lieve, that a routinely performed preoperative abdominal aortography i s not necessary. We found a remarkable number of anomalies of the inte rcostal and segmental arteries, which were only in part associated wit h deformities of the vertebral bodies. The kidneys seemed to be imbedd ed in the kyphotic concavity, partially with the inferior pole, partia lly in whole. In these cases the risk of intraoperative lesion seems h igher. We found a number of cases with unilateral agenesis of the kidn eys in the patients examined by us. Therefore we suggest the use of no ninvasive methods prior to surgery in order to evaluate the presence o f malpositions or malformations of the kidneys.