Guidelines of the Japanese Society for Pediatric Neurosurgery for Treatment of Myelomeningocele

Prenatal surgery for fetal myelomeningocele （ MMC ） repair has become more common since publication of the Management of Myelomeningocele Study （ MOMS ） in 2011. Treatment guidelines published by the Congress of Neurological Surgeons in 2019 recommend prenatal MMC repair when possible. However, this is not practical in Japan as fetal surgery research here has just begun. Therefore, the academic research group of the Japanese Society for Pediatric Neurosurgery （ JSPN ） has established a subcommittee to develop guidelines for MMC treatment that focus on postnatal repair and care of the MMC patient. Important issues to be addressed include prenatal MMC diagnosis, diagnosis of tethered spinal cord, timing and method of surgery for tethered cord, and treatment of late complications. Collaboration with obstetri-cians, pediatric urologists, pediatric orthopedic surgeons, and pediatricians will be essential. The initial JSPN guidelines will review and discuss issues specific to neurosurgery in newborns and infants and are currently being developed in accordance with the Medical Information Network Distribution Service （ MINDS ） Manual for Clinical Practice Guideline Development of the Japan Council for Quality Health Care.