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A study of the clinical profile and outcome of spina bifida

Authors: Theophilus Nikita Kumar and Ramesh M.K

Int J Med Res Health Sci.2016, 5, 2:8-12 | pdf PDF Full Text

ABSTRACT:
Neural tube defects (NTDs) are a group of congenital anomalies characterized by defects in dorsal midline
structures, including neural tissue, dura, muscle, bone and/or skin. The clinical presentations and the follow-up of
these patients requires attention to various end organs besides the nervous system. To evaluate the clinical profile
and surgical outcome of children with spina bifida. Out of a total of 74 patients treated at our institute for spina
bifida between June 2013 to august 2015, 74 cases of spina bifida were analyzed retrospectively and prospectively.
The clinical profile, radiological findings and urodynamic studies were recorded. Craniospinal MRI was done in
patients to screen for Arnold Chiari malformations and monitoring of hydrocephalus was done as a management
protocol at our institute for these children. All these patients except two underwent surgery for correction and
closure of the spinal defect. Associated anomalies were treated accordingly. They were clinically assessed over a
mean follow up period of 1.3years, ranging from 2months to 2½ years. 73% of the patients presented in the neonatal
age group. Of which, 72% presented with a visible sac over the back.72% of the cases were Myelomeningocoeles.
79% of the defects were in the lumbosacral region.30% presented with sensorimotor loss or bladder bowel
incontinence. Sensorimotor improvement was seen in 12.5% after repairing the defect with the help of physiotherapy
and braces. 30% of the patients were diagnosed to have hydrocephalus, of which 33% required a CSF diversion
procedure. The postoperative course of spina bifida repair was found to be uneventful in 90% of the patients.
Key words: Neural Tube Defect, Spina Bifida, Myelomeningocoele

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