LONG-TERM NEUROLOGICAL OUTCOME OF SURGICAL REPAIR OF LIPOMYELOMENINGOCELE IN INFANTS

Abstract

Background: Lipomyelomeningocele is a form of closed spinal dysraphism associated with tethering of the spinal cord and progressive neurological dysfunction. Surgical repair during infancy aims to prevent neurological deterioration; however, long-term outcomes remain variable.

Objective: To evaluate the late neurological outcomes of surgical repair of lipomyelomeningocele in infants and identify factors associated with unfavorable neurological outcomes.

Methods: This retrospective observational study was conducted in the Department of Pediatric neurosurgery, Children Hospital &The Institute of Child Health, Lahore from January 2022 to December 2022, included 40 infants who underwent surgical repair of lipomyelomeningocele. Demographic, clinical, radiological, operative, and follow-up data were collected from medical records.

Results: The mean age at surgery was 6.84 ± 2.71 months. Females were more common, 24 (60.0%), and the most frequent lesion location was lumbar, 19 (47.5%). Preoperative motor weakness was present in 11 (27.5%) infants, bladder dysfunction in 10 (25.0%), and low-lying conus or tethered cord on MRI in 34 (85.0%). Overall favorable outcome was achieved in 34 (85.0%) infants, including 13 (32.5%) who improved and 21 (52.5%) who remained stable. Neurological deterioration occurred in 6 (15.0%) infants. Untethering was observed in 5 (12.5%) cases and was significantly associated with unfavorable outcome.

Conclusion: Surgical repair of lipomyelomeningocele in infants resulted in favorable long term neurological outcomes in most patients. Early diagnosis, timely surgical repair, and long-term multidisciplinary follow-up are essential to reduce delayed neurological deterioration and untethering-related complications.