Surgical outcome of meningomyelocele and short-term prognostic factors: A retrospective cohort study

Neurochirurgie. 2024 Dec 18:101626. doi: 10.1016/j.neuchi.2024.101626. Online ahead of print.

Abstract

Introduction: Meningomyelocele is the most common congenital anomaly. It is associated with significant complications and can result in morbidity and mortality. The present study aims to identify short-term prognostic markers by investigating the characteristics of patients with meningomyelocele during hospitalization.

Methods: This is a retrospective study for patients with meningomyelocele who underwent surgery between 2019 and 2022. Preoperative and postoperative characteristics of the patients were statistically analyzed.

Results: Of the total of 161 patients included in the study, 137 (85.1%) were female and 24 (14.9%) were male. Examination of the relationship between the preoperative characteristics of the patients and mortality showed a significant correlation with Apgar scores at the first and fifth minutes (p < 0.01). Comparison of the preoperative and postoperative characteristics of the patients showed that those with necrosis at the wound site had significantly lower 1-min and 5-min Apgar scores (p < 0.001), experienced motor deficits (p < 0.001), and underwent a delayed surgery (p = 0.048). Analysis of patients requiring postoperative ventriculoperitoneal (VP) shunt placement showed significant associations with low 1-min and 5-min Apgar scores (p < 0.001) and motor deficits (p < 0.001).

Conclusions: The present study demonstrated that low Apgar scores, surgical timing, defect size, and neurological deficits were associated with the length of hospital stay and prognosis. Postoperative complications significantly prolonged the follow-up period of patients. We found that the Apgar score has a significant effect on both complications and mortality.

Keywords: Apgar scores; Meningomyelocele; Postoperative complications.