Alteraciones neurológicas asociadas al nivel de lesión de espina bífida en pacientes pediátricos del Hospital Dr. Roberto Gilbert Elizalde período 2013 - 2017.

Abstract

Background: Myelomeningocele represents the most severe form of dysraphisms due to exposure of the spinal cord, meninges, cerebrospinal fluid and nerve roots of the affected area; generating variable neurological defects that depend on the location and extension of the lesion. Existing studies do not mention the level of spinal cord injury and have focused on aetiology and a limited number of variables. Objective: To determine the association between the level of spina bifida lesion and neurological alterations in pediatric patients of the Hospital Dr. Roberto Gilbert Elizalde period 2013 - 2017. Materials and Methods: Retrospective, observational, cross-sectional, analytical study; in which 175 patients who met the inclusion criteria were evaluated, using the IREP myelomeningocele classification modified by CANEO. Results: Regarding the level of EB lesion, the lumbosacral location (group 3) according to the CANEO classification represents 88.24%, with the female sex being the most affected 50.86% and 49.4% male. Mean time of repair of the MMC 28 hours after birth and mean age of surgical correction of one (1) year after the first intervention (hydrocephalus, tethered cord). In the clinical characteristics, it was observed: MMC 97.66%, hydrocephalus 69.01%, neurogenic bladder 60.23%, tethered cord 19.30% and Arnold Chiari type II malformation 12.28%. Regarding the association of neurological alterations and the level of injury, no significant relationship was observed, however, myelomeningocele was present in 100% of group 0; 98.6% in group 3 and 87.50% in group 2. Conclusions: No significant relationship was observed between the level of injury and neurological alterations, since the frequency of appearance was similar at all levels.