Limits...
Spinal dysraphism: A challenge continued to be faced by neurosurgeons in developing countries.

Agrawal A, Sampley S - Asian J Neurosurg (2014)

Bottom Line: Mothers of 15 children did not seek any regular antenatal checkup and only 13 mothers received folic acid supplementation during pregnancy.The mean hospital stay was 7 days (range, 5 days to 31 days; median, 10 days).A large number of factors influence the outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Narayna Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India.

ABSTRACT

Objectives: The incidence of spinal dysraphism has significantly decreased over the last few decades, all over the world; however, still the incidence is much higher in developing countries with poor socioeconomic status.

Materials and methods: The present study includes all patients managed for spinal dysraphism over a period of one year (January 2011-December 2011). Details including demographics, antenatal care history, site and type of lesion, neurological examination, imaging finding, associated congenital anomalies, management offered, and outcome were recorded.

Results: A total of 27 children were operated for spinal dysraphism during the study period (17 males and 11 females). Median age was 120 days (age range, 1 day to 6 years). Mothers of 15 children did not seek any regular antenatal checkup and only 13 mothers received folic acid supplementation during pregnancy. Fourteen children were delivered at home and 13 were at hospital. The most common site was lumbosacral region (67.8%). Seven patients had rupture of the sac at the time of presentation, one child had local infection, and four patients had hydrocephalus (requiring shunt before surgical repair). Two patients developed hydrocephalus at follow up, needing shunt surgery. The mean hospital stay was 7 days (range, 5 days to 31 days; median, 10 days).

Conclusion: Spinal dysraphism is still a major public health problem in developing countries. Management of patients with spinal dysraphism is complex and needs close coordination between pediatrician, neurologist, neurosurgeon, and rehabilitation experts. A large number of factors influence the outcome.

No MeSH data available.


Related in: MedlinePlus

Clinical photograph showing ruptured meningocele sac that was repaired
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4129580&req=5

Figure 3: Clinical photograph showing ruptured meningocele sac that was repaired

Mentions: A total of 27 patients were operated for spinal dysraphism during one-year period. There were 17 males and 11 females. Median age was 120 days (age range, 1 day to 6 years). Fifteen mothers did not seek regular antenatal checkup and similar number did not receive folic acid supplementation during pregnancy. Fourteen patients underwent home delivery and 13 patients underwent hospital delivery. The most common site was lumbosacral region (67.8%) [Figure 1]. Seven patients had rupture at the time of presentation, one child had local infection, and four patients had hydrocephalus (requiring shunt before surgical repair) [Figure 2]. The mean hospital stay was 7 days (range, 5 days to 31 days; median, 10 days). Five of 7 patients who had rupture of the meningocele sac developed meningitis and succumbed to it [Figure 3]. There was no improvement in neurological function in any of the patients. Fourteen patients remained the same after surgery and 10 patients deteriorated in neurological functions. Of these 10 patients, four patients improved to preoperative neurological status at three-month follow-up. Remaining children were doing well at follow-up with variable amount of neurological deficits.


Spinal dysraphism: A challenge continued to be faced by neurosurgeons in developing countries.

Agrawal A, Sampley S - Asian J Neurosurg (2014)

Clinical photograph showing ruptured meningocele sac that was repaired
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129580&req=5

Figure 3: Clinical photograph showing ruptured meningocele sac that was repaired
Mentions: A total of 27 patients were operated for spinal dysraphism during one-year period. There were 17 males and 11 females. Median age was 120 days (age range, 1 day to 6 years). Fifteen mothers did not seek regular antenatal checkup and similar number did not receive folic acid supplementation during pregnancy. Fourteen patients underwent home delivery and 13 patients underwent hospital delivery. The most common site was lumbosacral region (67.8%) [Figure 1]. Seven patients had rupture at the time of presentation, one child had local infection, and four patients had hydrocephalus (requiring shunt before surgical repair) [Figure 2]. The mean hospital stay was 7 days (range, 5 days to 31 days; median, 10 days). Five of 7 patients who had rupture of the meningocele sac developed meningitis and succumbed to it [Figure 3]. There was no improvement in neurological function in any of the patients. Fourteen patients remained the same after surgery and 10 patients deteriorated in neurological functions. Of these 10 patients, four patients improved to preoperative neurological status at three-month follow-up. Remaining children were doing well at follow-up with variable amount of neurological deficits.

Bottom Line: Mothers of 15 children did not seek any regular antenatal checkup and only 13 mothers received folic acid supplementation during pregnancy.The mean hospital stay was 7 days (range, 5 days to 31 days; median, 10 days).A large number of factors influence the outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Narayna Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India.

ABSTRACT

Objectives: The incidence of spinal dysraphism has significantly decreased over the last few decades, all over the world; however, still the incidence is much higher in developing countries with poor socioeconomic status.

Materials and methods: The present study includes all patients managed for spinal dysraphism over a period of one year (January 2011-December 2011). Details including demographics, antenatal care history, site and type of lesion, neurological examination, imaging finding, associated congenital anomalies, management offered, and outcome were recorded.

Results: A total of 27 children were operated for spinal dysraphism during the study period (17 males and 11 females). Median age was 120 days (age range, 1 day to 6 years). Mothers of 15 children did not seek any regular antenatal checkup and only 13 mothers received folic acid supplementation during pregnancy. Fourteen children were delivered at home and 13 were at hospital. The most common site was lumbosacral region (67.8%). Seven patients had rupture of the sac at the time of presentation, one child had local infection, and four patients had hydrocephalus (requiring shunt before surgical repair). Two patients developed hydrocephalus at follow up, needing shunt surgery. The mean hospital stay was 7 days (range, 5 days to 31 days; median, 10 days).

Conclusion: Spinal dysraphism is still a major public health problem in developing countries. Management of patients with spinal dysraphism is complex and needs close coordination between pediatrician, neurologist, neurosurgeon, and rehabilitation experts. A large number of factors influence the outcome.

No MeSH data available.


Related in: MedlinePlus