Factors Affecting the Outcomes in Children Post-Myelomeningocoele Repair in Northeastern Peninsular Malaysia
- Author:
Badrisyah Idris
- Publication Type:Journal Article
- Keywords:
children, myelomeningocoele, neurosurgery, neural tube defects, spina bifida, spinal cord
- From:Malaysian Journal of Medical Sciences
2011;18(1):52-59
- CountryMalaysia
- Language:English
-
Abstract:
Background: The present study aimed to evaluate the impact of multiple factors and
outcomes (ambulatory function and sphincter function) on children with myelomeningocoele
(MMC) following surgical repair.
Method: A retrospective chart review of children that underwent surgery for MMC in the
Hospital Universiti Sains Malaysia from 1 January 1990 to 31 December 2004 was conducted. Only
those children who were followed-up for at least 18 months after the operation were included in the
study.
Results: A total of 42 children with MMC were included in the study. Approximately 79%
of the MMC were located in the lumbosacral and sacral regions. Thirty (71.4%) of the children had
hydrocephalus, and 28 (67.7%) had a cerebrospinal fluid (CSF) shunt inserted. An analysis of the
association between the predictors of ambulatory status revealed that hydrocephalus (P = 0.013),
the presence of a CSF shunt (P = 0.005), intact motor function at L3 and below (P < 0.001), and the
presence of deep tendon reflexes (P < 0.001) were good factors of ambulatory status. Only 16.7% of
the children did not have urinary or faecal incontinence. Hydrocephalus (P = 0.049) and low-level
MMC (P = 0.028) were significantly associated with sphincter control.
Conclusion: Multiple factors contributed to the outcomes in post-MMC repair children in
terms of ambulation and sphincter function following a repair of MMC. The Spina Bifida Neurological
Scale (SBNS) should be applied during the management of these children to identify neurological
deterioration.
- Full text:W020151022538693945104.pdf
