Incidence and Outcomes of Diastematomyelia in Spina Bifida Patients
DOI:
https://doi.org/10.36552/pjns.v27i3.891Abstract
Objective: To determine the prevalence of diastematomyelia in spina bifida patients and to assess the efficacy of surgical intervention.
Material and Methods: This prospective research study was conducted at the Jinnah Postgraduate Medical Center in Karachi in the Neurosurgery department. We included 55 patients after fulfilling the inclusion criteria. All of the patients had craniospinal MRI, and the results, as well as any anomalies discovered, were noted for future reference during their therapy. Patients suffering from these diseases were treated surgically, which included sac excision and repair, cord detethering, and ventriculoperitoneal shunting. Throughout the postoperative period, all of these patients' outcomes were documented and assessed.
Results: The majority of patients were under 1 month old (29 patients, 53.70%), whereas 13 patients were between one month and 1 year old. The patients were 2.8 years old on average. There were 23 males (42.60%) and 32 females (58.18%). Dermal sinuses, hypertrichosis, and skin dimples (signs of spina bifida occulta), with prevalence rates of 5.55 percent, 3.70 percent, and 1.85 percent, respectively. Spina bifida occulta was less frequent (17 cases) than spina bifida aperta (37 occurrences). 33 patients (61.11%) have myelomeningocele, followed by meningocele in three (5.5%), lipomyelomeningocele in six (10.9%), diastematomyelia in six (10.9%), dermal sinus in two (3.70%), along with spinal lipoma in one (1.85%) instance.
Conclusion: The overall prevalence of Diastematomyelia in patients with spinal dysraphism is low. However vigilant assessment and management is crucial for optimal surgical benefit.
Keywords: Diastematomyelia, Spina Bifida, Spinal Dysraphism.
References
Tortori-Donati P, Rossi A, Cama A. Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification. Neuroradiology. 2000;42(7):471-91.
Padmanabhan R. Etiology, pathogenesis and prevention of neural tube defects. Congenit Anom (Kyoto). 2006;46(2):55-67.
Volpe J. Neural tube formation and prosencephalic development. In: Volpe J, ed. Neurology of the Newborn. 4th ed. Philadelphia, Pa: WB Saunders; 2001:3– 44.
Brea CM, Munakomi S. Spina Bifida. 2023 Aug 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32644691.
Humphreys RP, Hendrick EB, Hoffman HJ. Diastematomyelia. Clin Neurosurg. 1983;30:436-56. doi: 10.1093/neurosurgery/30.cn_suppl_1.436.Bowman RM, McLone DG, Grant JA, Tomita T, Ito JA. Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 2001;34(3):114-20.
Bowman RM, McLone DG, Grant JA, Tomita T, Ito JA. Spina bifida outcome: a 25-year prospective. Pediatr Neurosurg. 2001;34:114 –120.
Acharya UV, Pendharkar H, Varma DR, Pruthi N, Varadarajan S. Spinal dysraphism illustrated; Embroyology revisited. Indian J Radiol Imaging.
;27(4):417-426.
Hudgins RJ, Gilreath CL. Tethered spinal cord following repair of myelomeningocele. Neurosurg Focus. 2004;16(2):E7
Nikolic D, Petronic I, Cvjeticanin S, Brdar R, Cirovic D, Bizic M, Konstantinovic L, Matanovic D. Gender and morphogenetic variability of patients with spina bifida occulta and spina bifida aperta: prospective population-genetic study. Hippokratia. 2012;16(1):35-9.
Sahmat A, Gunasekaran R, Mohd-Zin SW, Balachandran L, Thong MK, Engkasan JP, Ganesan D, Omar Z, Azizi AB, Ahmad-Annuar A, Abdul-Aziz NM. The Prevalence and Distribution of Spina Bifida in a Single Major Referral Center in Malaysia. Front Pediatr. 2017;5:237.
Elgamal EA, Hassan HH, Elwatidy SM, Altwijri I, Alhabib AF, Jamjoom ZB, Murshid WR, Salih MA. Split cord malformation associated with spinal open neural tube defect. Saudi Med J. 2014;35 Suppl 1(Suppl 1):S44-8.
Kumar R, Singh SN. Spinal dysraphism: trends in northern India. Pediatr Neurosurg. 2003;38(3):133-45.
Mehta DV. Magnetic Resonance Imaging in Pediatric Spinal Dysraphism with Comparative Usefulness of Various Magnetic Resonance Sequences. J Clin Diagn Res. 2017; 11(8):TC17-TC22.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Sagheer Ahmed, Iram Bokhari, Tanveer Ahmed, Rabail Akbar, Raheel GoharThe work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).
