Spinal dysraphism: trends in northern India.

Area of Science:

• Neurology
• Pediatric Surgery
• Medical Imaging

Background:

• Spinal dysraphism encompasses a spectrum of congenital anomalies affecting the neural tube.
• Understanding the clinical presentation, imaging characteristics, and surgical outcomes is crucial for effective management.

Purpose of the Study:

• To evaluate the clinical profiles, image findings, and surgical outcomes in 155 patients with spinal dysraphism.
• To identify common presentations, associated anomalies, and postoperative complications.

Main Methods:

• A prospective and retrospective study of 155 patients diagnosed with spinal dysraphism.
• Clinical evaluation, craniospinal MRI, and surgical assessment with a mean follow-up of 3.6 years.
• Categorization into open (meningomyelocele, meningocele, myelocystocele) and occult (split cord malformation, dermal sinus) types.

Main Results:

• Open spina bifida, particularly meningomyelocele (MMC), was prevalent (119 cases).
• Common clinical findings included lower limb weakness, sensory loss, and sphincteric dysfunction.
• Frequent imaging findings were low-lying cord, hydrocephalus, and Chiari malformation.
• Postoperative complications included CSF leak, pseudomeningocele, and wound infection.

Conclusions:

• A significant subset of open spinal dysraphism cases present with underlying split cord malformation (SCM), termed complex spina bifida.
• Hydrocephalus incidence in Indian patients with spinal dysraphism appears lower than in Western populations.
• Early surgical intervention guided by comprehensive MRI screening is advised for optimal patient outcomes.