Pattern of Presentation of Spinal Dysraphism: A Study of 72 Patients in Hayatabad Medical Complex Peshawar, Pakistan

Abstract

Objective: To review the pattern of presentation and current understanding of patients with spinal dysraphism in our local population.
 Material and Methods: Cases of spinal dysraphism of any gender and age were admitted via OPD, emergency or referred from another department were included in the study. Information on demographics, developmental history, presenting symptoms , presence/absence of back swelling, hairy patches, a nevus, dimple, an appendage/ skin tag, lower limb function, sensory/ motor deficit, bowel and bladder dysfunction were recorded. MRI spine was done in all patients to know the exact diagnosis.
 Results: Out of 72 cases, 52 (72.2%) presented with spina bifida Aperta (spina bifida cystica) while 20 (27.7%) with spina bifida occulta. Total 53 (73.6%) patients presented at the age of 0 – 1 years. 41 (56.9%) of the patient presented with visible sac, 35 (48.6%) swelling over the back, in 5 (6.9%) of patient have hairy patch and dermal sinus each, while 28 (38.8%) patients have neurological deficit. Most common type of spinal dysraphism was myelomeningocele 45 (62.5%). Postoperative course of patients with spinal dysraphism was found to be uneventful in 56 (77.7%), wound infection was seen in 11 (15.2%), deterioration of neurological status in 3 (4.16%) of cases.
 Conclusion: Spinal dysraphism is not an uncommon condition in our local population its clinical presentation and features are in line with internationally reported literature. Our population is least aware of the adverse neurological outcomes of the condition and face difficulties to access the adequate healthcare for spinal dysraphism.