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Malaysian Journal of Medical Sciences
School of Medical Sciences, Universiti Sains Malaysia
ISSN: 1394-195X
Vol. 18, No. 1, 2011, pp. 52-59
Bioline Code: mj11009
Full paper language: English
Document type: Research Article
Document available free of charge

Malaysian Journal of Medical Sciences, Vol. 18, No. 1, 2011, pp. 52-59

 en Factors Affecting the Outcomes in Children Post-Myelomeningocoele Repair in Northeastern Peninsular Malaysia
Idris, Badrisyah


Background: The present study aimed to evaluate the impact of multiple factors and outcomes (ambulatory function and sphincter function) on children with myelomeningocoele (MMC) following surgical repair.
Methods: A retrospective chart review of children that underwent surgery for MMC in the Hospital Universiti Sains Malaysia from 1 January 1990 to 31 December 2004 was conducted. Only those children who were followed-up for at least 18 months after the operation were included in the study.
Results: A total of 42 children with MMC were included in the study. Approximately 79% of the MMC were located in the lumbosacral and sacral regions. Thirty (71.4%) of the children had hydrocephalus, and 28 (67.7%) had a cerebrospinal fluid (CSF) shunt inserted. An analysis of the association between the predictors of ambulatory status revealed that hydrocephalus (P = 0.013), the presence of a CSF shunt (P = 0.005), intact motor function at L3 and below (P < 0.001), and the presence of deep tendon reflexes (P < 0.001) were good factors of ambulatory status. Only 16.7% of the children did not have urinary or faecal incontinence. Hydrocephalus (P = 0.049) and low-level MMC (P = 0.028) were significantly associated with sphincter control.
Conclusion: Multiple factors contributed to the outcomes in post-MMC repair children in terms of ambulation and sphincter function following a repair of MMC. The Spina Bifida Neurological Scale (SBNS) should be applied during the management of these children to identify neurological deterioration.

children, myelomeningocoele, neural tube defects, neurosurgery, spina bifida, spinal cord

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