Initial Treatment of Meningocele and Myelomeningocele Lesion in Children

Background: Myelomeningocele is a severe form of spina bifida. The disease significantly impacts survival and neurological outcomes in children. The purpose of this study is to investigate the effect of in-time assessment and surgical intervention on functional outcomes in children with MMC. Meth...

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Main Authors: Ammar Anwer, Naveed Ahmad Khan, Obaid Ur Rehman, Javaria Siddiq, Abrar Ullah Khan
Format: Article
Language:English
Published: ziauddin University 2025-01-01
Series:Pakistan Journal of Medicine and Dentistry
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Online Access:https://ojs.zu.edu.pk/pjmd/article/view/3081
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author Ammar Anwer
Naveed Ahmad Khan
Obaid Ur Rehman
Javaria Siddiq
Abrar Ullah Khan
author_facet Ammar Anwer
Naveed Ahmad Khan
Obaid Ur Rehman
Javaria Siddiq
Abrar Ullah Khan
author_sort Ammar Anwer
collection DOAJ
description Background: Myelomeningocele is a severe form of spina bifida. The disease significantly impacts survival and neurological outcomes in children. The purpose of this study is to investigate the effect of in-time assessment and surgical intervention on functional outcomes in children with MMC. Methods: A retrospective study was conducted on medical records of 60 children who underwent MMC repair between January 2016 and December 2019. ERC/62/24/06 were categorized into six groups based on the timing of assessment and surgical intervention. The KA Bennett classification system was used for functional outcomes grading. A Kaplan-Meier and log-rank test was used to find survival rates.  Results: Survival analysis revealed that early surgical intervention significantly reduced mortality rates compared to conservative treatment (p<0.05). Children treated within 24 hours (Group C) had higher survival rates (94.4%) compared to those with delayed or no closure (Groups A and B). Functional improvements were noted across all groups, with the highest in groups undergoing early surgery. The presence of hydrocephalus negatively impacted survival, with early closure groups showing lower mortality (26%) compared to those with delayed closure (55.1%). Group E showed fewer cases of hydrocephalus (62%) and smaller thoracic lumbar lesions were excluded from comparisons due to its unique profile assessed on days 3-4 post-birth. Conclusion: Early surgical intervention within the first 24 hours post-birth significantly improves survival and functional outcomes in children with MMC compared to delayed treatment or conservative management.
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publishDate 2025-01-01
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series Pakistan Journal of Medicine and Dentistry
spelling doaj-art-54fd0f4012fe452f95b920c1df9508672025-01-19T20:18:33Zengziauddin UniversityPakistan Journal of Medicine and Dentistry2313-73712308-25932025-01-0114110.36283/ziun-pjmd14-1/014Initial Treatment of Meningocele and Myelomeningocele Lesion in ChildrenAmmar Anwer0https://orcid.org/0000-0002-7652-8050Naveed Ahmad Khan1Obaid Ur Rehman 2Javaria Siddiq 3Abrar Ullah Khan 4University College of Medicine and Dentistry, The University of Lahore, Pakistan.University College of Medicine and Dentistry The University of Lahore, Pakistan. Mayo Hospital Lahore, Pakistan. King Edward Medical University, Mayo Hospital Lahore,Pakistan.Mayo Hospital Lahore, Pakistan. Background: Myelomeningocele is a severe form of spina bifida. The disease significantly impacts survival and neurological outcomes in children. The purpose of this study is to investigate the effect of in-time assessment and surgical intervention on functional outcomes in children with MMC. Methods: A retrospective study was conducted on medical records of 60 children who underwent MMC repair between January 2016 and December 2019. ERC/62/24/06 were categorized into six groups based on the timing of assessment and surgical intervention. The KA Bennett classification system was used for functional outcomes grading. A Kaplan-Meier and log-rank test was used to find survival rates.  Results: Survival analysis revealed that early surgical intervention significantly reduced mortality rates compared to conservative treatment (p<0.05). Children treated within 24 hours (Group C) had higher survival rates (94.4%) compared to those with delayed or no closure (Groups A and B). Functional improvements were noted across all groups, with the highest in groups undergoing early surgery. The presence of hydrocephalus negatively impacted survival, with early closure groups showing lower mortality (26%) compared to those with delayed closure (55.1%). Group E showed fewer cases of hydrocephalus (62%) and smaller thoracic lumbar lesions were excluded from comparisons due to its unique profile assessed on days 3-4 post-birth. Conclusion: Early surgical intervention within the first 24 hours post-birth significantly improves survival and functional outcomes in children with MMC compared to delayed treatment or conservative management. https://ojs.zu.edu.pk/pjmd/article/view/3081MyelomeningoceleSpinal DysraphismHydrocephalusPediatric Neurosurgery
spellingShingle Ammar Anwer
Naveed Ahmad Khan
Obaid Ur Rehman
Javaria Siddiq
Abrar Ullah Khan
Initial Treatment of Meningocele and Myelomeningocele Lesion in Children
Pakistan Journal of Medicine and Dentistry
Myelomeningocele
Spinal Dysraphism
Hydrocephalus
Pediatric Neurosurgery
title Initial Treatment of Meningocele and Myelomeningocele Lesion in Children
title_full Initial Treatment of Meningocele and Myelomeningocele Lesion in Children
title_fullStr Initial Treatment of Meningocele and Myelomeningocele Lesion in Children
title_full_unstemmed Initial Treatment of Meningocele and Myelomeningocele Lesion in Children
title_short Initial Treatment of Meningocele and Myelomeningocele Lesion in Children
title_sort initial treatment of meningocele and myelomeningocele lesion in children
topic Myelomeningocele
Spinal Dysraphism
Hydrocephalus
Pediatric Neurosurgery
url https://ojs.zu.edu.pk/pjmd/article/view/3081
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AT obaidurrehman initialtreatmentofmeningoceleandmyelomeningocelelesioninchildren
AT javariasiddiq initialtreatmentofmeningoceleandmyelomeningocelelesioninchildren
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