Myelomeningocele about 100 Cases and Review of Literature

Abstract

Spina bifida is a group of vertebro-medullary malformations with a common defect in neural tube closure during embryonic life. Myelomeningocele (MMG) is the most frequent anatomical subtype. The aim of this study is to investigate the epidemiology, diagnosis and treatment of MMG. It is a retrospective study based on a series of 100 cases of MMG recorded over 10 years in the neurosurgery department of Chu Ibn Rochd, Casablanca, between 2009 and 2019. The frequency of occurrence is an average of 10 cases per year; consanguinity is found in 24% of cases, the most predominant location was lumbar (87%) and accompanied by a motor deficit in 61% of cases, cerebral CT is performed in 94% of cases. Hydrocephalus was present in 83% of patients, orthopedic disorders were found in 75% of cases, 90% of cases studied underwent surgery for the malformation and 83% benefited from ventriculoperitoneal shunting. Our results are similar to those reported in the literature, with a 100% rate of patients operated on in developed countries, and MMG frequently located in the lumbar region. The rate of hydrocephalus associated with MMG is 88%, the associated orthopedic malformations according to other studies vary from 46% to 93.9%, and the rate of patients benefiting from a DVP varies between 60% and 90%. Improving the long-term prognosis requires the collaboration of neurosurgeons, urologists, orthopedists, psychologists, physiotherapists and parents, which will facilitate the patient’s autonomy and social integration.