Pathological Patterns and Clinical Presentations of Spinal Dysraphism in Different Age Groups

Abstract

Background: Spinal dysraphism (SD) results from failure of fusion of the caudal neural tube. Its incidence is 2-4 / 1000 live births. Objective: To study the pathological patterns and clinical presentations of spinal dysraphism and its association with some known predisposing factors of congenital disorders. Study Design: Descriptive cross-sectional study. Settings: Department of Neurosurgery, Dow University of Health Sciences and Civil Hospital, Karachi Pakistan. Duration: Six years from October 2015 to September 2018. Methods: This study was conducted in 100 consecutive patients, who were diagnosed as cases of spinal dysraphism based on history, clinical examination, and MRI appearances. Results: Large majority of patients (64 out of 100 or 64%) were in the first year of life. The most common clinical presentations were muscular weakness (70%), foot deformity (40%), bladder disturbance (36%) and skin abnormality (28%). Myelomeningocele was the most common pathological pattern (56%) followed by lipomyelomeningocele (16%), diastematomyelia (10%), congenital dermal sinus (8%), hypertrophied filum terminale (8%) and meningocele (2%). Most patients came from a lower socioeconomic stratum and there was no association with consanguinity and maternal age and only two patients had affected siblings. Conclusion: Knowledge regarding different types of spinal dysraphism and their presentations is essential for all medical practitioners.