Objective: Neural tube defects are a heterogeneous and complex group of congenital central nervous system anomalies involving that involve the failed closure of the vertebral column. The spinal cord is frequently affected, and neural tube defects substantially increase the risk of disability and death within the first year of life. Neural malformations are often associated with abnormalities in other organ systems. This study presents our clinical experiences regarding the development and comorbidities of infants with neural tube defect and compares them with the literature. Materials and Methods: This retrospective study included 47 patients (24 females, 23 males) who underwent surgical treatment for neural tube defect in the neurosurgery department of Sivas Cumhuriyet University Faculty of Medicine Training and Research Hospital between 2000 and 2020. Results: Of the 47 patients, 34 (72.34%) had myelomeningocele and 13 (27.65%) had meningocele. Lesion location was thoracolumbar in 38 patients (80.85%), lumbar in 5 (10.63%), lumbosacral in 3 (6.38%), and cervical in 1 patient (2.12%). Twenty-seven patients (57.44%) underwent ventriculoperitoneal shunting due to hydrocephalus. Thirty patients (63.82%) had Chiari malformation type II, 13 (27.65%) had cranial anomalies, and 1 (2.12%) had Down syndrome. In 9 patients, the conus medullaris terminated at or below the L3 vertebral body (19.14%). Two patients (4.25%) died. Conclusion: Because of their multidimensional nature, neural tube defects have various effects on individuals, families, society, and the field of medicine. This study represents a small group of patients with neural tube defects. Cases should be included from other centers to compile more comprehensive data about patients with neural tube defects in Turkey.
___
[1]Gandy K, Castillo H, Rocque BG, et al. Neurosurgical training and global health education: systematic review of challenges and benefits of in-country programs in the care of neural tube defects. Neurosurg Focus 2020; 48: E14.
[2]Turhan AH, Isik S. Neural tube defects: A retrospective study of 69 cases. Asian J Neurosurg 2019; 14: 506-9.
[3]Copp AJ, Adzick NS, Chitty LS, et al. Spina bifida. Nat Rev Dis Primers 2015; 1: 15007.
[4]Greene ND, Copp AJ. Neural tube defects. Annu Rev Neurosci 2014; 37: 221-42.
[5]Zahed Pasha Y, Vahedi A, Zamani M, et al. Prevalence of Birth Defects in Iran: A Systematic Review and Meta-Analysis. Arch Iran Med 2017; 20: 376-85.
[6]Davis MC, Hopson BD, Blount JP, et al. Predictors of permanent disability among adults with spinal dysraphism. J Neurosurg Spine 2017; 27: 169-77.
[7]Canfield MA, Mai CT, Wang Y, et al. The association between race/ethnicity and major birth defects in the United States, 1999-2007. Am J Public Health 2014; 104: e14-23.
[8]Brei T, Houtrow A. Spina Bifida. J Pediatr Rehabil Med. 2017; 10: 165-166.
[9]Ulsenheimer MM, Antoniuk SA, Santos LH, et al. Myelomeningocele: A Brazilian University Hospital experience. Arq Neuropsiquiatr. 2004; 62: 963-8.
[10]Farmer DL, Thom EA, Brock JW 3rd, et al. The management of myelomeningocele study: Full cohort 30-month pediatric outcomes. Am J Obstet Gynecol 2018; 218: 256.e1-13.
[11]Gaitanis J, Tarui T. Nervous system malformations. Continuum 2018; 24: 72-95.
[12]Ryabykh SO, Pavlova OM, Savin DM, et al. Surgical Management of Myelomeningocele-Related Spinal Deformities. World Neurosurg 2018; 112: e431-41.
[13]North T, Cheong A, Steinbok P, et al. Trends in incidence and long-term outcomes of myelomeningocele in British Columbia. Childs Nerv Syst 2018; 34 :717-24.
[14]Nejat F, Kamali S, El Khashab M. Interfrontal encephalocele: a rare feature of forehead in hydrocephalic myelomeningocele patients. Clinical feature, probable mechanisms, and management. Childs Nerv Syst 2013; 29: 1349-52.
[15]McDowell MM, Lee PS, Foster KA, Greene S. The use of external ventricular drainage to reduce the frequency of wound complications in myelomeningocele closure. Pediatr Neurosurg 2018; 53: 100-7.
[16]World Health Organization, Congenital anomalies, 2016
[17]Copp AJ, Stanier P, Greene ND. Neural tube defects: Recent advances, unsolved questions, and controversies. Lancet Neurol 2013; 12: 799-810.
[18]Manning SM, Jennings R, Madsen JR. Pathophysiology, prevention, and potential treatment of neural tube defects. Ment Retard Dev Disabil Res Rev 2000; 6: 6-14.
[19]Mitchell LE, Adzick NS, Melchionne J, et al. Spina bifida. Lancet 2004; 364: 1885-95.
[20]Hannay HJ, Dennis M, Kramer L, et al. Partial agenesis of the corpus callosum in spina bifida meningomyelocele and potential compensatory mechanisms. J Clin Exp Neuropsychol 2009; 31: 180-94.
[21]Çelik HT, Meliboyev M, Nizamov İ, et al. Meningomyelocele and Arnold‐Chiari malformation: Evaluation of 45 cases. Cocuk Sagligi ve Hastaliklari Dergisi 2010; 53: 10‐6.
[22]McLone DG, Dias MS. The Chiari II malformation: Cause and impact. Childs Nerv Syst 2003; 19: 540‐50.
[23]Oakeshott P, Hunt GM, Poulton A, et al. Open spina bifida: birth findings predict long-term outcome. Arch Dis Child 2012; 97: 474-6.