J Korean Neurosurg Soc 51 | June 2012 Table 1. Demographic characteristics and treatment periods of the patients with meningomyelocele Values All patients (n=30) Group 1 (n=13) Maternal age, years* 26.7±5.4 26.4±6.09 Gestational weeks* 37.7±2.7 38.3±1.1 Birth weight, g* 2967±755 3013±451 Head circumference, cm* 35.8±3.8 36.3±1.5 Gender (male) 16 (53.3%) 7 (53.8%) Mode of delivery (Caesarean) 22 (73.3%) 10 (76.9%) Diameter of defect, cm* 4.33±1.2 4.31±1.1 Hydrocephalus (n) 25 (83.3%) 9 (69.2%) Duration of antibiotic treatment, days* 13±6.4 10±1.6 Operation time, days* 8.2±5.9 3.38±1.04 Duration of hospital stay, days* 30±25.1 13.2±2.4 *Values are given as mean±standard deviation. †Results of statistical comparisons between groups 1 and 2 Table 2. Localization of meningomyelocele, neurological status, compli- cations and additional anomalies of the study population Localization of meningomyelocele Thoracic Thoracolumbar Lumbar Lumbosacral Neurological status Normal Paraparetic Paraplegic Total complications Local infection Bladder dysfunction CSF fistulas Meningitis Ventriculitis Detected additional anomalies Hydrocephaly Pes equinovarus Chiari II malformation Unilateral renal agenesis Omphalocele Esophageal atresia Transposition of the great arteries (TGA) 1 (3.3%) 3 (10%) 12 (40%) 14 (46.6%) 7 (23.3%) 13 (43.3%) 10 (33.3%) 16 (53.3%) 3 (10%) 7 (23.3%) 3 (10%) 2 (6.7%) 1 (3.3%) 25 (83.3%) 7 (23.3%) 5 (16.7%) 1 (3.3%) 1 (3.3%) 1 (3.3%) 1 (3.3%) MMC-associated anomalies, size of the MMC defect and its lo- calization were recorded. For those who underwent surgery, the timing of surgery as well as the post-operative duration of hos- pital stay (patients without complication and did not need any treatment for addition anomalies are discharged), length of an- tibiotic course (vancomycin or cefotaxime for meningitis/ven- triculitis and/or local infection) and morbidity were also re- corded. Patients were stratified into two groups based on the timing of surgery. Those who underwent surgery within the first 5 days after birth were placed in group 1 while group 2 was comprised of those who were operated later than 5 days. Group 2 (n=17) 26.8±5.12 37.1±3.5 2932±937 35.4±5 9 (52.9%) 12 (70.6%) 4.35±1.3 16 (94.1%) 15.3±7.7 11.88±7.4 42.8±27.1 p-value† 0.83 0.24 0.77 0.83 0.96 0.51 0.92 0.09 <0.05 <0.001 <0.001 Statistical analysis Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) for Microsoft Windows, version 15.0 (SPSS Inc., Chicago, IL, USA). Comparisons between groups were made using the chi-square test for categorical variables and the Student’s t-test for numerical variables. Values were pro- vided as either percentage or mean±standard deviation, were applicable. A p-value of <0.05 was considered indicative of sta- tistical significance. RESULTS The complete medical records of 30 patients who were re- trieved were deemed suitable for analysis, the demographic and clinical characteristics of whom are summarized in Table 1. None of the mothers of the subjects included in this study had used any form of folic acid supplementation either before or during their pregnancies. A diagnosis of MMC was made ante- natally by ultrasonography in 18 patients (40%). Only 3 of the births (10%) were a result of a consanguineous marriage. Localization of the MMC, neurological status, associated anomalies and complications are summarized in Table 2. The most frequently encountered localization was the lumbosacral area (46.6%), with 76.6% of patients having lower extremity neu- rological abnormality. Overall, MMC-related complications were observed in 16 patients (53.3%), the most common complication being bladder dysfunction. Hydrocephaly was the most com- monly observed anomaly, occurring in 25 (83.3%) of our pa- tients, followed by other anomalies (Table 2). Cranial ultrasonography confirmed the presence of hydro- cephaly in 25 (83.3%) patients. Overall, the mean lateral ventri- cle diameter was 20.2±4.8 mm, with no discernable difference between groups (p>0.05). All patients with hydrocephaly were subjected to scanning by cranial computerized tomography to confirm the diagnosis as well as to screen for the presence of other anomalies. Comparisons between groups revealed that patients in group 1 who underwent surgery within 5 days of life had significantly 360