Van Tıp Dergisi (Jan 2019)
Retrospective evaluation of neonatal patients treated with the diagnosis of lumbosacral meningocele or meningomyelocele
Abstract
INTRODUCTION: Meningocele/meningomyelocele is the most common malformation of medullaspinalis. In this study, clinical experience with meningocele / meningomyelocele treatment was reported and it was aimed to assist the patient with such pathology in subsequent approaches. METHODS: 36 newborn patients were retrospectively reviewed who had diagnosis as lumbosacral meningocele/meningomyelocele in our clinic between 2013 and 2017. In this study; applied surgical techniques, associated pathologies, neurological and physical examination findings, complications encountered were analyzed and reported. RESULTS: Meningocele was detected in 6 (16.7%) and meningomyelocele was detected in 30 (83.3%) patients. In meningomyelocele patients, the number of girls (63.3%) was found to be higher. The neurological deficit was detected at high rate (90%) in the patients with meningomyelocele. Hydrocephalus was frequently accompanied with both meningocele and meningomyelocele (50%, 46.7%). The most important clinical finding for secondary hydrocephalus after pouch excision was an increase in head circumference for meningocele patients and CSF leakage for meningomyelocele patients. Ventriculoperitoneal shunt (70.6%) was the most common treatment for hydrocephalus. Shunt infection developed in 11.1% of the patients with meningomyelocele who underwent shunt treatment. The most common causative agent was Staphylococcus epidermidis (75%). DISCUSSION AND CONCLUSION: Hydrocephalus was the most common pathology detected in meningocele/meningomyelocele patients. Ventriculoperitoneal shunt is the most commonly used technique in the treatment of hydrocephalus. Shunt infection developed in the patients with non-intact sac before operation. Therefore, providing CSF sterilization with external shunt then internal shunt operation may be a more appropriate treatment option.
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