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Spinal dysraphism: A challenge continued to be faced by neurosurgeons in developing countries
1Department of Neurosurgery, Narayna Medical College Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India.
Asian Journal of Neurosurgery
|August 16, 2014
Summary
Spinal dysraphism remains a significant public health issue in developing nations, particularly affecting infants and children. Early diagnosis and multidisciplinary management are crucial for improving outcomes in these complex cases.
Area of Science:
- Pediatric Surgery
- Neurology
- Public Health
Background:
- Spinal dysraphism incidence has decreased globally but remains high in low-socioeconomic developing countries.
- Factors contributing to high incidence in developing nations include limited access to antenatal care and folic acid supplementation.
Purpose of the Study:
- To analyze the management and outcomes of pediatric spinal dysraphism cases in a developing country setting.
- To highlight the challenges and complexities in managing spinal dysraphism.
Main Methods:
- A retrospective study of 27 children managed for spinal dysraphism between January 2011 and December 2011.
- Data collected included demographics, antenatal history, lesion characteristics, neurological status, imaging, associated anomalies, management, and outcomes.
Main Results:
- The majority of mothers (15/27) lacked regular antenatal checkups, and only 13 received folic acid.
- The lumbosacral region was the most common site (67.8%), with complications like sac rupture and hydrocephalus observed.
- Mean hospital stay was 7 days, with some patients requiring shunt surgery for hydrocephalus.
Conclusions:
- Spinal dysraphism is a persistent public health concern in developing countries.
- Effective management requires a coordinated multidisciplinary approach involving pediatricians, neurologists, neurosurgeons, and rehabilitation specialists.
- Numerous factors significantly impact patient outcomes.
