Department of Neurosurgery, School of Medicine, Emory University, Atlanta, GA, USA.
Department of Neurosurgery, Urmia University of Medical Sciences, Urmia, Iran.
Childs Nerv Syst. 2024 Sep;40(9):2859-2863. doi: 10.1007/s00381-024-06455-z. Epub 2024 Jun 7.
Myelomeningocele (MMC) is a prevalent form of neural tube defect. Despite advancements in treatment, MMC still poses significant health risks, including complications leading to chronic disability and mortality. Identifying prognostic risk factors for early outcomes is crucial for tailored intervention strategies.
This prospective study involved newborns and infants diagnosed with MMC who underwent surgery between 2020 and 2023 at Urmia University of Medical Sciences. Demographic data and surgical outcomes were collected, and participants were followed up for six months. Statistical analyses were conducted using descriptive statistics, Chi-Square, and independent t-test.
The study included 29 MMC cases, with an incidence rate of 1.4 per 10,000 live births. Lesions were predominantly located in the lumbar spine. Although mortality rates appeared to increase with ascending lesion sites, this trend was not statistically significant. Short-term outcomes revealed high morbidity and mortality rates, with neurological deficits being the most prevalent complication. Multivariable analysis identified head circumference as a significant predictor of adverse outcomes (IRR = 1.37, 95% CI = 1.02 to 1.86, p = 0.04). Furthermore, an increase in birth weight was associated with a reduction in the incidence of requiring a ventriculoperitoneal shunt (IRR = 0.99, 95% CI = 0.998 to 0.999, p = 0.02).
This prospective study highlights prognostic risk factors for early outcomes in MMC patients, emphasizing the need for personalized intervention strategies. By addressing modifiable risk factors and implementing targeted interventions, healthcare providers can strive to improve outcomes and enhance the quality of life for MMC patients.
脊髓脊膜膨出（MMC）是神经管缺陷的一种常见形式。尽管在治疗方面取得了进展，但 MMC 仍然存在重大健康风险，包括导致慢性残疾和死亡的并发症。确定早期结局的预后风险因素对于制定个体化干预策略至关重要。
本前瞻性研究纳入了 2020 年至 2023 年在乌尔米亚医科大学接受手术治疗的 MMC 新生儿和婴儿。收集了人口统计学数据和手术结果，并对参与者进行了为期 6 个月的随访。使用描述性统计、卡方检验和独立 t 检验进行了统计分析。
研究纳入了 29 例 MMC 病例，发病率为每 10000 例活产儿中有 1.4 例。病变主要位于腰椎。尽管死亡率似乎随病变部位上升而增加，但这种趋势无统计学意义。短期结局显示发病率和死亡率较高，神经功能缺陷是最常见的并发症。多变量分析确定头围是不良结局的显著预测因素（IRR=1.37，95%CI=1.02 至 1.86，p=0.04）。此外，出生体重增加与需要脑室腹腔分流术的发生率降低相关（IRR=0.99，95%CI=0.998 至 0.999，p=0.02）。
本前瞻性研究强调了 MMC 患者早期结局的预后风险因素，强调需要制定个体化干预策略。通过解决可改变的风险因素并实施有针对性的干预措施，医疗保健提供者可以努力改善 MMC 患者的结局并提高其生活质量。
