Outcomes of delayed CSF diversion protocol in Infants with lumbosacral myelomeningocele: impact of timing of presentation on hydrocephalus development and postoperative complications.

In 30 seconds

This controlled clinical trial evaluated the outcomes of a delayed cerebrospinal fluid (CSF) diversion protocol in 186 infants with lumbosacral myelomeningocele (MMC) across two centers in Iraq. The study found that 76.8% of patients required VP shunt placement, with a significantly higher shunt-free rate in those presenting within 24 hours of birth (26.4% vs 17.4%).

Key findings

• 76.8% of infants required VP shunt placement, lower than the global rate of 82-90%.
• Shunt-free rate was significantly higher in the clean lesion group at 26.4% compared to 17.4% in the contaminated group.
• Postoperative complications were more frequent in the contaminated group, including wound infections (26.3% vs 15.1%).
• The clean lesion group underwent VP shunt placement earlier, at a median of 11-16 days post-repair.

Why it matters

The study highlights the critical role of timely hospital presentation in reducing complications and shunt dependency in infants with MMC. Understanding these dynamics can inform clinical practices and improve patient outcomes.