Closure of the myelomeningocele is performed immediately after birth if external cerebral spinal fluid (CSF) leakage is present and typically within the first 24-48 hours in the absence of CSF leakage. The surgery can be delayed for several days without additional problems. A delay gives families more time to deal with the shock and learn about the condition to enable them to participate to a greater degree in the decision-making process (Herz, 2004).

Steps in the closure procedure include making sure to have a watertight closure to avoid any infections. Postoperative complications include wound infection, central nervous system (CNS) infection, delayed wound healing, CSF leakage, additional neurological damage to the cauda equina, and acute hydrocephalus. Long-term complications include cord tethering and progressive hydrocephalus.