Korean J Spine.  2017 Mar;14(1):7-10. 10.14245/kjs.2017.14.1.7.

Determination of the Effect of Diameter of the Sac on Prognosis in 64 Cases Operated for Meningomyelocele

• EseoÄŸlu M
• EroÄŸlu A
• Kemer S
• Arslan M

• KMID: 2377781
• DOI: http://doi.org/10.14245/kjs.2017.14.1.7

Abstract

OBJECTIVE
To examine the effect of meningomyelocele sac size on prognosis by retrospective review of 64 cases operated for meningomyelocele between January 2009 and December 2012.
METHODS
We evaluated newborn babies operated for meningomyelocele by retrospectively reviewing their files for head circumference, location and with of the defect, accompanying anomalies, treatments administered, drugs that mother used during pregnancy. Based on the defect size, 3 patient groups were created as 0-24 cm² (group I), 25-39 cm² (group II), and 40 cm² and above (group III).
RESULTS
Throughout the study, 64 babies were evaluated. Mean head circumference was 37.4 cm (range, 30.7-50 cm). Based on their location, 49 of the defects (76.5%) were lumbar, 7 (10.9%) were thoracolumbar, 4 (6.2%) were thoracic, 3 (3.1%) were sacral, 1 (1.5%) was cervical. Mean size of the meningomyelocele sac was 4.7 cm×5.8 cm (range, 1 cm×1 cm"”10 cm×8 cm), 13 of the babies (20.3%) had skin defect requiring flap. According to accompanying anomalies, 47 of the babies (73.4%) had hydrocephalus, 7 (10.9%) had club foot, 1 (1.5%) had diastematomyelia, 1 (1.5%) had tethered cord. Thirty-nine of the babies (60.9%) had paraplegia, 10 (15.6%) had paraparesis, 8 (12.5%) had monoplegia; neurological examination in the remaining 7 babies was normal.
CONCLUSION
In our study, increased diameter of meningomyelocele sac was associated with greater amount of neural tissue within the sac, which worsens the prognosis. Sac localization was not changing prognosis but infection rates, hospitalization duration were increased in babies with bigger diameter of sacs.

Keyword

Meningomyelocele; Neural Tissue; Diameter of the Sac

MeSH Terms

Foot
Head
Hemiplegia
Hospitalization
Humans
Hydrocephalus
Infant, Newborn
Meningomyelocele*
Mothers
Neural Tube Defects
Neurologic Examination
Paraparesis
Paraplegia
Pregnancy
Prognosis*
Retrospective Studies
Skin