Outcome of Myelomeningocele Repair and Early Post-operative Complications

Abstract

Introduction: Neural tube defects are one of the most common congenital birth defects resulting in a significant number of physical, mental and social disabilities in the earlier years of life. Amongst the central nervous system anomalies which are reported in 31% of newborns with anomalies, myelomeningocele (MMC) is the most common of the central nervous system defects with upto 71% occurrence.
Objective: To determine frequency of post-operative complications in the repair of myelomeningocele.
Material and Method: This study was a Descriptive case series conducted at Pakistan Institute of Medical sciences (PIMS) Islamabad from March to September 2016. Consecutive (non-probability) sampling technique was used.Total of 156 patients were included in the study who presented in neurosurgical department of PIMS, Islamabad suffering from meningomyelocele. Mean Age of presentation of patients was 58.58 days ± 26.01 Std. deviation. 88 patients (56.4%) were males and 68 (43.6%) were females. 79 patients had size of defect < 5 cm, 68 patients had size of defect ranging from 5-10 cm and 9 patients had defect size > 10 cm in size. 21 patients (13.5%) wound showed signs of surgical site infection while 135 patients (86.5%) wounds healed satisfactorily. 37 patients (23.7%) had CSF leakage while 119 patients (76.3%) recovered completely. Post-operative pyrexia was noted in 141 patients (90.4%) while 15 patients (9.6%) remained afebrile. Post-operative Hydrocephalus was seen in 35 patients (22.4%) as compared to 121 patients (77.6%) with no hydrocephalus post operatively.
Conclusion: The study concluded that early diagnosis and prompt management is key to recovery of child. Early operation without subsequent complications is the backbone of treatment.