SHORT TERM OUTCOME OF SURGICAL MANAGEMENT OF PATIENTS WITH NEURAL TUBE DEFECT (SPINA BIFIDA)

Objective: To study short term out come of surgical management of patients with neural tube defect (Spina Bifida).Material and Methods: This study was conducted at Paediatric Surgery unit, Lady Reading Hospital, Peshawar from January 2003 to December 2005. Patients with neural tube defect in whom surgery was indicated were included in this study except those who had complete paraplegia, total incontinence of urine and faeces and associated life threatening major congenital malformation. After discharge from hospital the patients were followed up for 2.5 years.Results: Surgery was performed in 198 cases including 93 (46.97%) males and 105 (53.03%) females, ranging in age from one day to 18 months. There were 39 cases (19.70%) with meningocele, 144 cases (72.73%) with myelomeningocele, and 15 cases (7.58%) with lipomeningocele. Hydrocephalus observed in 42 cases (21.21%), was treated with VP shunt. Clubfeet deformities due to neurological defects were found in 12 cases (6.06%). Incontinence of urine and faeces was found in 39 cases (19.70%). Postoperative complications were observed in 24 cases (12.12%) including wound infection 18 cases (9.09%), wound dehiscence 3 cases (1.52%) and CSF leakage 3 cases (1.52%). Thirty four patients died (17.17%) and 27 patients were lost to follow-up.Conclusion: Management of neural tube defect requires proper assessment and appropriate decision for surgery. Proper selection of patients for surgery has a fair outcome