Plavskyi P. Emergency surgery of spinal dysraphisms complicated by liquorrhea or its threat

The thesis deals with synthesis and solving of an actual pediatric neurosurgery problem - improving diagnosis and treatment outcomes of children with spinal dysraphisms complicated by liquorrhea or its threat. The thesis is based on the analysis of the survey results and surgical treatment, follow-up data of 246 infants with spinal dysraphisms complicated by liquorrhea or its threat. The patients were treated in the Department of Pediatric Neurosurgery, SI "Institute of Neurosurgery named after Acad. A.P. Romodanov NAMS of Ukraine" from 2001 to 2012. A linear regression analysis of patient outcomes showed that the least favourable outcome occurred in meningomyelocele of breast-lumbar localization with the hernia sac rupture, symptoms of meningitis, hydrocephalus combined with multiple disabilities and other internal organs operated later than 72 hours after birth. The favourable outcomes were observed more frequently in children with meningocele of lumbosacral localization with no inflammation signs of the central nervous system operated in the first 24 hours of life (p<0,05, coefficient of multiple determination R2=0,44). The developed scheme of treatment allowed to increase the efficiency and improve the surgical treatment of children with spinal dysraphisms complicated by liquorrhea or its threat.