ABSTRACT
Objective: to assess the pattern, causes and frequency of Complication of Ventriculoperitoneal Shunt surgery in Paediatric patients
Material and Method: 404 patients with hydrocephalus were operated between the period of 2004 to 2013 in the Departments of Neurosurgery and Paediatric Surgery at Allied Hospital, Punjab Medical College, Faisalabad. All patients with provisional diagnosis of Hydrocephalus were admitted in the hospital, detailed history was recorded and general physical examination with special emphases on neurological examination. Diagnosis was confirmed on the basis of investigations like Cranial Ultrasonography, CT and MRI scanning. Data analysis was carried using Statistical package of social Sciences [SPSS]
Results: of the 404 patients 176[81.48%] were male and 40[18.51%] female. Shunt infection was the commonest complication [12.9%] followed by Blockage [8.3%]. Shunt related mortality was [1.8%]. The mean age among the patients showing disconnection was 20.7 months compared to mean age of 7.8 months for not having this complication[p<0.04]
Conclusion: infection remains the most significant complication of VP Shunt surgery. Ventriculoperitoneal Shunt operation should be considered a major surgical procedure. Children with VP shunt should receive follow-up through the transition the adult hood
ABSTRACT
Objective: surgical outcome of tethered cord syndrome
Study Design: retrospective descriptive
Period and Place of study: Neurosurgery Department Allied Hospital Faisalabad over 6 months from October 1, 2014 to March 28, 2015
Materials and Methods: forty patients were selected at Neurosurgical Department, Allied Hospital, Faisalabad with age ranging from 2 months to 27 years[average 2.58 years]. These were assessed clinically and their orthopedic and urological aspects were also assessed. MRI of relevant area was advised. Counselling was done regarding surgery under general anesthesia and its outcome. Laminectomy or laminotomy was done. Cord was detethered from its attachments from dura, and, in case of lipomeningocele, from its extradural component. In case of diastometomyelia, bony spur was extirpated and dura- plasty was done. Tight filum terminale was divided. Surgery was done using microsurgery techniques. Postoperative assessment was done immediately at the time of discharge, at 6 and 12 months
Results: a total of 40 patients, M:F ratio was5:3. Average age was 2.58 years.Age was ranging from 2 months to 27 years. Power improved in 44 % to grade 5/5 and 37% in grade 4/5 at one year. There was 65 % improvement in anal sphincters and 71% improvement in urinary sphincters at one year
Conclusion: our clinical and neurological evaluation showed satisfactory outcome after surgery, particularly when performed before the onset of irreversible deficit. Neurological status prior to surgery has profound impact on the outcome