World neurosurgery · 2026
Time Intervals in Neurosurgical Care and Their Impact on Postoperative In-Hospital Outcomes in Myelomeningocele Patients at BLINDED.
СтатьяНазвание и аннотация: Перевод в очереди
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Limann Bernice, Adjei Emmanuel Osei, Boateng Maame D, Sekyere Nana A B O, Adatare Dennis, Awindaogo Joseph, Banson Mabel, Abdullah Hadi M
Аннотация
INTRODUCTION: Myelomeningocele (MMC) is a severe form of spina bifida associated with significant morbidity. Early neurosurgical intervention is recommended to optimize outcomes, yet delays in presentation and treatment remain common in resource-limited settings. This study evaluated the clinical characteristics, surgical outcomes, and the effect of treatment intervals on postoperative complications in patients with MMC.
METHODS: A retrospective review of 88 patients with MMC at BLINDED was conducted. Sociodemographic characteristics, clinical presentation, shunting status, surgical outcomes, and time intervals from birth to treatment milestones were collected. Logistic regression examined the association between treatment intervals and postoperative complications, including surgical site infections, cerebrospinal fluid (CSF) leaks, and shunt infections.
RESULTS: The median age at presentation was 14(2-58) days, and the mean birth weight was 2.9 ± 0.5 kg. Hydrocephalus was present in 41% of patients, while 34% presented with a ruptured sac. Lumbosacral defects were most common (61%). Primary shunting was performed in 41% of patients, secondary shunting in 21%, and 39% did not require shunting. Overall, 29% developed postoperative complications, including surgical site infections in 27%, and in-hospital mortality in 5%. The median interval from birth to surgery was 100 days (IQR 38-199). No significant association was identified between treatment intervals and postoperative complications.
CONCLUSION: Substantial delays to surgery were observed, although no statistically significant association was detected between timing and adverse postoperative outcomes in this cohort. Nevertheless, the high rates of surgical site infection and CSF leak emphasize the need for improved perioperative care, while efforts to reduce delays and optimize management remain essential.
METHODS: A retrospective review of 88 patients with MMC at BLINDED was conducted. Sociodemographic characteristics, clinical presentation, shunting status, surgical outcomes, and time intervals from birth to treatment milestones were collected. Logistic regression examined the association between treatment intervals and postoperative complications, including surgical site infections, cerebrospinal fluid (CSF) leaks, and shunt infections.
RESULTS: The median age at presentation was 14(2-58) days, and the mean birth weight was 2.9 ± 0.5 kg. Hydrocephalus was present in 41% of patients, while 34% presented with a ruptured sac. Lumbosacral defects were most common (61%). Primary shunting was performed in 41% of patients, secondary shunting in 21%, and 39% did not require shunting. Overall, 29% developed postoperative complications, including surgical site infections in 27%, and in-hospital mortality in 5%. The median interval from birth to surgery was 100 days (IQR 38-199). No significant association was identified between treatment intervals and postoperative complications.
CONCLUSION: Substantial delays to surgery were observed, although no statistically significant association was detected between timing and adverse postoperative outcomes in this cohort. Nevertheless, the high rates of surgical site infection and CSF leak emphasize the need for improved perioperative care, while efforts to reduce delays and optimize management remain essential.