Spinal Dysraphism: Common Entity in Pediatric Neurosurgery

Abstract

Introduction: Neural tube defects are among the most common congenital malformations and a major cause of health problems in surviving children, especially in developing countries. Although the incidence of spinal dysraphism has significantly decreased over the last few decades, all over the world; however, the incidence is much higher in developing countries with poor socioeconomic status. The social and economic impact of this disease is not well documented; however, up to 75% of adult survivors may be dependent on parents or other care providers. Aims and Objectives: The aim of this study is to review the demographic profile, clinical pretentions, surgical management and short term outcome of patients presenting with spinal dysraphism Methodology: This is a prospective observational study of cases of spinal dysraphism managed surgically over the period of 2 years from March 2014 to February 2016 in Department of Neurosurgery at Tribhuvan University Teaching Hospital (TUTH), Kathmandu Nepal. Results: Out of total 97 cases, there was male preponderance. In about 40% of population there was no history of proper ANC visit and most of them were from low economic status. Lump on the back was the commonest clinical findings. Lumbar Myelomeningocele was the commonest anatomical location of dysraphism. More than one third of patients needed CSF diversion postoperatively. Conclusion: Myelomeningocele is a common NTDs. Open dysraphism may not always present as a lump. Delay in seeking medical attention may be due to illiteracy. None of the mother had taken folic acid prior to conception.

Keywords

• hydrocephalus
• myelomeningocele
• spinal dysraphism