13^th World Pediatric Congress

Statement of the Problem: Spina Bifida (SB) is a common birth defect resulting from incomplete closure of the neural tube during the first month of pregnancy. SB at children is difficult and unsolved problem in pediatric neurosurgery. Pathology of the lumbosacral area is 30-50% of the total number of spinal dysraphism at children. The purpose of this study is to determine the optimal terms and methods of surgical treatment of SB on lumbosacral area in infants.

 

Methodology & Theoretical Orientation: 19 newborns with SB were operated. 16 children aged from 1 to 10 days and 3 from 11 to 28 days. Depending on the anatomical variants of SB, the patients were divided into: Meningocele (21.05%); myelomeningoradiculocele (26.32%); myelomeningocele (31.58%) and myeloschisis (21.05%).

 

Findings: 6 children were operated from 1 to 3 days after birth. The best results for surgery were age of 7 to 10 days (10 children). The term of surgical operation from 11 till 28 days for 3 children was due to the presence of herniaʼs coats infection and purulence, which demanded the implementation of preoperative preparation for 5-7 days. The disadvantage of all methods of surgical treatment of SB there is a danger of iatrogenic damage to neural elements during surgery, depending on the quality of its performance.

 

Conclusion & Significance: During the execution of surgical treatment SB is necessary to use radiculolysis with precision microsurgical excision of all cicatricial adhesions, cerebrospinal fluid cysts and other intraradicular formations and spinal canal’s revision. Dysfunction of the pelvic organs (urine and anal incontinence) and lower limbs are observed in 68.42% of children operated on SB in the neonatal period that requires further development of methods of their surgical correction at the later age.