Spina Bifi da Cystica; features and early postoperative outcomes an experience in Kampala
Introduction: Spina Bifi da is one of the most serious developmental disability of the infant. The prevalence of Spina Bifi da varies across time, region, race and ethnicity. Worldwide, it accounts for as many as 4.7 in 10,000 live births. Although Spina bifi da in its entirely is commonly seen in neurosurgical practice there is sparse literature on this disabling congenital anomaly in the Ugandan context. This study therefore aimed at describing the clinical features and early post operative outcomes.
Methods: A prospective descriptive study recruited children with Spina Bifi da Cystica admitted to Neurosurgical ward over a period of 11 months from May 2010 to March 2011, at Uganda’s National Referral Hospital. Clinical presentations of these patients were obtained by performing a general and neurological examination and using a standardized questionnaire. The patients were followed up for two weeks to establish early outcomes.
Result: A total of 51 patients with Spina Bifi da Cystica were studied, representing 3.9% of all patients admitted on the unit that period. Out of those 54.9% were males and 45.1% were females. The mean age of their mothers was 23.8 years and the second birth rank was the mostly affected. Family history of Spina Bifi da was present in 7.8%. Nearly all patients (98%) had myelomeningocele with a most common site being lumbosacral (47.1%). Hydrocephalus was noted in 72.5% of patients before surgery and talipes equinovarus was the other most associated congenital anomaly. Forty three patients were operated on. The rest 8 patients died before surgery. The mean preoperative hospital stay was 17.6 days.
Conclusion: Patients had long pre operative lapse before the definitive management was offered and all the deaths occurred during this period. Exploration of factors responsible for this delay may enhance opportunities for timely intervention.
Keywords: Spina Bifi da Cystica, surgery, early outcomes