SHORT TERM OUTCOME OF SURGICAL MANAGEMENT OF PATIENTS WITH NEURAL TUBE DEFECT (SPINA BIFIDA)

Abstract

Objective: To study short term out come of surgical management of patients with neural tube defect (Spina

Bifida).

Material and Methods: This study was conducted at Paediatric Surgery unit, Lady Reading Hospital,

Peshawar from January 2003 to December 2005. Patients with neural tube defect in whom surgery was

indicated were included in this study except those who had complete paraplegia, total incontinence of

urine and faeces and associated life threatening major congenital malformation. After discharge from

hospital the patients were followed up for 2.5 years.

Results: Surgery was performed in 198 cases including 93 (46.97%) males and 105 (53.03%) females,

ranging in age from one day to 18 months. There were 39 cases (19.70%) with meningocele, 144 cases

(72.73%) with myelomeningocele, and 15 cases (7.58%) with lipomeningocele. Hydrocephalus observed in

42 cases (21.21%), was treated with V.P shunt. Clubfeet deformities due to neurological defects were found

in 12 cases (6.06%). Incontinence of urine and faeces was found in 39 cases (19.70%). Postoperative

complications were observed in 24 cases (12.12%) including wound infection 18 cases (9.09%), wound

dehiscence 3 cases (1.52%) and CSF leakage 3 cases (1.52%). Thirty four patients died (17.17%) and 27

patients were lost to follow-up.

Conclusion: Management of neural tube defect requires proper assessment and appropriate decision for

surgery. Proper selection of patients for surgery has a fair outcome