Wound complications after neonatal spinal dysraphism surgery carry a high risk of infection and, when dural opening is required, potential cerebrospinal fluid (CSF) leakage. While negative-pressure wound therapy (NPWT) is well established in adults, evidence in neonatal neurosurgery—especially with portable systems—remains scarce.

A term female neonate underwent surgery on day 2 for complex open lumbosacral spinal dysraphism with an exophytic mass first identified at birth. Imaging and surgery showed split cord malformation, low tethered cord, and mature teratoma with intradural extension. En bloc resection, filum terminale transection, and watertight dural closure were performed. On postoperative day (POD) 12, wound dehiscence developed, resulting in a 5.5 × 4.0 cm skin defect without dural exposure. After directed wound care, portable NPWT (SNaP®) was initiated on POD21 (−125 mmHg, continuous) for 22 days, with dressing changes every 3–4 days. Complete epithelialization occurred by POD43 without CSF leak, infection, or reoperation. At one year, neurological and scar outcomes were satisfactory, with no pseudomeningocele or recurrence on MRI.

In a PRISMA-guided search, we identified 4 publications reporting 6 pediatric cases of NPWT after dysraphism-related spinal surgery with dural opening and/or exposed dura. Published cases exclusively used conventional VAC® systems, and data in intradural settings remain limited; no prior report described SNaP® use in this context.

After secure watertight dural closure, appropriate interface protection, and optimized nutritional support, portable NPWT (SNaP®) may represent a feasible rescue option for neonatal lumbosacral wound dehiscence following intradural surgery.