Comparison of Outcomes of Early and Late Surgical Interventions in Lipomeningomyelocele (LMMC) and Lipomeningocele (LMC)

Authors

  • Shahzeb Ahmad
  • Shakil Mashori
  • Syeda Kiran Zahra1
  • Rana Muhammad Usama
  • Abdul Hanan
  • Shmama Tu Zahra

DOI:

https://doi.org/10.36552/pjns.v26i4.821

Keywords:

Lipomeningocele, Lipomeningomyelocele

Abstract

Objectives:  The study compared the signs and symptoms of post-operative complications in early vs. late intervention lipomeningomyelocele (LMMC) and lipomeningocele (LMC).

Materials and Methods:  We compared the clinical and surgical data between two groups i.e., lipomeningomyelocele (n = 189) and lipomeningocele (n = 64), and their early vs. late surgical interventions for 3 years from January 2018 to July 2021. We included patients of both genders (n = 253) with lipomeningomyelocele or lipomeningocele aged up to 7 years. A detailed neurological exam i.e., sensory, motor, and cerebellar signs was performed to evaluate the patients.

Results:  The presentation of LMMC (74.7%) was very high compared to LMC (25.3%). 74.7% underwent detethering of the spinal cord, as they had cord tissue coming out of the defect. 25.2% had only meninges coming out of the bony deficiency and performed dural repairs. 47 patients had incontinence which was improved postoperatively. Sixty-nine patients had hydrocephalus which was treated with VP shunt or ETV. 23 patients had diastematomyelia which is a bony spur duly repaired intra-operatively. 50 presented with paraplegia and 19 cases with club feet. The majority of patients in both groups, reported for Power would fall between 3/5-4/5. For patients who underwent late intervention, 7 presented with post-operative incontinence, 12 with hydrocephalus, 12 with CSF leakage, and 13 with paraplegia.

Conclusion:  If performed on time, surgical intervention in lipomeningocele and lipomeningomyelocele yields good results. Early intervention is substantially better for managing post-op CSF leakage and incontinence than late intervention.

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Published

2022-12-23

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Original Articles