Management of Spinal Dysraphism-Our Clinical Experience

Abstract

Background: Spinal dysraphism refers to a group of developmental abnormalities that affect the spinal cord and its surrounding structures. The main goals of treatment of spinal dysraphism are to prevent further damage to the spinal cord and to improve the patient's neurological function and quality of life.Aim of the Study: The aim of this study was to assess the management of spinal dysraphism .Methods: This cross-sectional study was conducted in Department of Pediatric Neuro Surgery, Bangladesh Shishu Hospital and Institute, Sher E Bangla Nagar, Dhaka 1207, Bangladesh, during the period from 1st April 2020 to 31st March 2021. Total 1052 patients were admitted under Neurosurgery department (SU IV) from them 93 patients had spinal dysraphism. After excluding patients with encephalocele, lipomeningocele, meningocele and DORB, total 60 patients with myelomeningocele were included in this study.Result: Majority of the subjects (71%) were less than a week old. there was a slight female preponderance (54%) among the study subjects. The most affected (83.33%) region of the spine among the study subjects was lumbosacral. The data showed that 65% of the study subjects had no lower limb movement, while 35% of them had slight movement. In the study, all study subjects had abnormal bowel and bladder habits. In the study, the majority (62%) had a moderate ventricular index level before operation. About 83.33% of the study subjects had a satisfactory outcome after the surgery, while 6.66% had poor outcomes, and 1.66% of the study subjects died after the surgery. The data showed that 80% of the study subjects had a severe Ventricular Index after two weeks of surgery, while 20% had a moderate Ventricular Index. The data also indicated that 85% of the study subjects had a healthy wound after surgery, while 15% had an unhealthy wound.Conclusion:From the findings of our study, it can be concluded that for improving the quality of life of the patients with spinal dysraphism, surgery is the prominent treatment accompanied by optimal post-operative care. Surgery of spinal dysraphism is associated with higher satisfactory rate and lower post-operative complications.