Initial Treatment of Meningocele and Myelomeningocele Lesion in Children

Abstract

Background: Myelomeningocele is a severe form of spina bifida. The disease significantly impacts survival and neurological outcomes in children. The purpose of this study is to investigate the effect of in-time assessment and surgical intervention on functional outcomes in children with MMC. Methods: A retrospective study was conducted on medical records of 60 children who underwent MMC repair between January 2016 and December 2019. ERC/62/24/06 were categorized into six groups based on the timing of assessment and surgical intervention. The KA Bennett classification system was used for functional outcomes grading. A Kaplan-Meier and log-rank test was used to find survival rates. Results: Survival analysis revealed that early surgical intervention significantly reduced mortality rates compared to conservative treatment (p<0.05). Children treated within 24 hours (Group C) had higher survival rates (94.4%) compared to those with delayed or no closure (Groups A and B). Functional improvements were noted across all groups, with the highest in groups undergoing early surgery. The presence of hydrocephalus negatively impacted survival, with early closure groups showing lower mortality (26%) compared to those with delayed closure (55.1%). Group E showed fewer cases of hydrocephalus (62%) and smaller thoracic lumbar lesions were excluded from comparisons due to its unique profile assessed on days 3-4 post-birth. Conclusion: Early surgical intervention within the first 24 hours post-birth significantly improves survival and functional outcomes in children with MMC compared to delayed treatment or conservative management.

Keywords

• Myelomeningocele
• Spinal Dysraphism
• Hydrocephalus
• Pediatric Neurosurgery