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Spinal dysraphism.

A Jindal1, A K Mahapatra, R Kamal

  • 1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi.

Indian Journal of Pediatrics
|May 8, 2000
PubMed
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Spinal dysraphism (SD) is a neural tube malformation affecting 2-4/1000 births. Surgical outcomes in 119 patients showed varied improvements in motor, sensory, and continence functions, with common complications including CSF leak and wound infection.

Area of Science:

  • Neurosurgery
  • Developmental Biology
  • Pediatric Surgery

Background:

  • Spinal dysraphism (SD) encompasses a spectrum of congenital malformations involving the neural tube and surrounding structures.
  • The incidence of SD is estimated at 2-4 per 1000 live births.
  • Presentation of SD can occur at any age, with a significant proportion of patients presenting in adulthood.

Purpose of the Study:

  • To analyze the clinical presentation, radiological findings, surgical outcomes, and complications in a cohort of patients with spinal dysraphism.
  • To evaluate the effectiveness of surgical intervention in improving neurological deficits and functional status.
  • To identify common cutaneous markers and radiological features associated with spinal dysraphism.

Main Methods:

  • A retrospective study of 119 patients surgically treated for spinal dysraphism between January 1991 and June 1996.

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  • Data collection included patient demographics, clinical presentation, neurological examination findings, radiological investigations, surgical procedures, and post-operative outcomes.
  • Analysis of motor and sensory deficits, continence, complications, and need for re-operation.

    • Main Results:

    • The lumbar and lumbosacral regions were the most frequently affected sites (74.7%).
    • Common presenting symptoms included lower limb weakness (74%), difficulty walking (54%), and muscle atrophy (41.2%).
    • Post-operative improvements were observed in 43 patients, with notable gains in sensory function (20 patients), motor function (18 patients), and continence (15 patients). Complications included CSF leak (8%) and wound infection (6%).

    Conclusions:

    • Surgical intervention for spinal dysraphism can lead to significant improvements in neurological and functional status, although outcomes vary.
    • Early presentation in infancy is associated with better potential for recovery.
    • Awareness of cutaneous markers and radiological findings is crucial for timely diagnosis and management of spinal dysraphism.