Myelomeningocoele in Nigeria: Has There Been Any Change with Improved Neurosurgery Care?

Ephraim Onyia, Mark Chikani, Wilfred Mezue, Enoch Uche, Izuchukwu Iloabachie, Matthew Mesi, Emeka Okorie


A 6 year retrospective study of the clinical and pathological profile of myelomeningoceles who had neurosurgical care at the neurosurgical unit of the University of Nigeria Teaching Hospital Enugu, South-East Nigeria from 2010-2015 was done. The review found 57 males (54.2%) and 47 females (45.8%). Patients age ranged from 1 day to 7 years. More patients (59.6%) presented outside the neonatal age group. Fifty patients (48.1%) live in urban setting while 54 (51.9%) were from a rural setting. The lumbo-sacral area is the most common location, followed by thoraco-lumbar, sacral, and the thoracic regions representing 90.4%, 5.8%, 2.9%, and 1% respectively. Associated anomalies were seen in 57 patients (54.8%) with neurologic abnormalities been the most common (49% of all cases) followed by hydrocephalus (44.2%). Limb paralysis was above L2 in 45.1%. There is an association between increasing paternal age and presence of associated abnormalities (p = 0.027). Significant association was also found between place of residence and associated anomalies (p 0.009).Surgical procedures were performed in 84 patients (80.8%). The postoperative mortality was 5.9%. Ignorance of pre-conception folic acid use was demonstrated. Ante-natal preventive strategies need to be reviewed, while multi-disciplinary management with good social support is recommended post-natally.


Myelomeningocoele; Folic acid; Limb paralysis.

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