Shahzeb AhmadResident neurosurgery, Pakistan
Title: Comparison of outcomes of early and late surgical interventions in Lipomeningomyelocele (LMMC) and Lipomeningocele (LMC)
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.
Shahzeb Ahmad has completed his MBBS at the age of 23 years from Ameer ud din Medical College lahore, Punjab Pakistan. He is the FCPS resident neurosurgery department at Punjab Institute of Neurosciences , Pakistan. He has over 3 publications. He has passed step 1 USMLE