Early Neurological Outcome of Surgical Repair of Lipomyelomeningocele in Infants

Objective:  A prospective cohort study was aimed to evaluate the early neurological outcome of surgery among infants having lipomyelomeningocele. Material and Methods:  The study was conducted at the Department of Pediatric neurosurgery, Children Hospital &The Institute of Child Health, Lahore from January 2019 to June 2019.A total of 50 pediatric patients, both male and female, aged 3 months to 1 year, with lipomyelomeningocele (symptomatic or asymptomatic) who presented to the out-patient department were included in the study. Group A included those cases who were aged <6 months and Group B were aged >6 months. All patients underwent standard surgical procedures for the treatment of lipomyelomeningocele.  Results:  Out of a total of 50 infants, there was 32 (64.0%) female. Overall, the mean age was 7.39 ± 2.63 months. The lumbar area having mass on the back was the most frequently seen in 23 (46.0%) infants. Group A included 20 (40.0%) infants while Group-B had 30 (60.0%). Low lying cord was the commonest neurological finding noted among 25 (50.0%). Complete Excision of Lipoma was done among 48 (96.0%) infants. Post-surgery, no significant difference was found on day-3 and day-10 between study groups (P > 0.05). Early outcome at 6-months intervals was found to be associated with significantly improved neurological function grades in Group-A (p = 0.030). Conclusion:  Surgical management of lipomyelomeningocele is a safe procedure. An early treatment approach even in asymptomatic infants is recommended to reduce neurological deterioration.