• WF Rakotondraibe Service de Neurochirurgie, CHU PZAGA Mahajanga
  • RT Andrianaivo Service de Neurochirurgie, CHUJRA Antananarivo
  • MG Tsiaremby Service de Neurochirurgie, CHU Tanambao Antsiranana
  • S Raotoson Service de Chirurgie Maxillofaciale, CHU PZAGA, Mahajanga
  • NH Raveloharimino Service de Néonatologie, CHU PZAGA Mahajanga
  • N Rabesandratana Service de Néonatologie, CHU PZAGA Mahajanga
  • D Andrianarimanana Service de Pédiatrie, CHU PZAGA Mahajanga
  • C Andriamamonjy Service de Neurochirurgie, CHUJRA Antananarivo
Keywords: surgery, spinal dysraphism, hydrocephalus, meningitis



The incidence of spinal dysraphism has declined dramatically over the past few decades all over the world; however, the incidence is still much higher in developing countries with low socioeconomic status.


The objective of this study was to describe the epidemioclinical and etiological profile of spina bifida in Mahajanga and report the reality of its management in a precarious environment.

Materials and methods

The current study includes all patients treated for spina bifida aperta over a three-year period (May 2017- April 2020). Details including demographics, antenatal care history, site and type of lesion, neurological examination, imaging results, associated birth defects, management offered and results were recorded .


A total of 15 children were operated on for spinal dysraphism during this study period (10 boys and 5 girls). The median age was 2.65 years with an extreme of 2 days and 13 years. Six of the mothers of our patients took Fenugreek (Angamay) as a decoction before conception and during pregnancy and only 5 mothers received folic acid supplementation during pregnancy. We discovered 9 myelomeningoceles, 5 meningocele and one spinalipoma in which the lumbosacral location predominated (40%). Five patients had a ruptured sac at the time of consultation, four children had a local infection, and two had hydrocephalus requiring ventricular bypass. One patient died from ventriculitis.


SBA remains a major public health problem in developing countries. Its management is complex and requires close multidisciplinary coordination.


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Aguiar Marcos JB, Campos Agela S, Aguiar Regena ALP. Defeitos de fechamento do tubo neural e fatores associados em recém-nascidos vivos e natimoros. J Pediatr(RIO J), 2003; 79:129-34.

Bemora JS, Andrianaivo RT, Masina NA, Ratovondrainy W, Rabararijaona M, Andriamamonjy C. Epidemiological Clinical and Profile of Cranio-spinal Dysraphisms in Madagascar. European Journal of Medical and Health Sciences, Dec. 2020 ; 6(2). DOI: http://dx.doi.org/10.24018/ejmed.2020.2.6.60.

Bodin CR, Rasmussen MM, Tabor A, Westbom L, Tiblad E, Ekelund CK, et al. Ultrasound in Prenatal Diagnostics and Its Impact on the Epidemiology of Spina Bifida in a National Cohort from Denmark with a Comparison to Sweden. Biomed Res Int. 2018; 2018: 8.

Cragan JD, Robert HE, Edmonds ID. Surveillance of anencephaly and spina bifida and the impact of prenatal diagnosis—united states, 1985-1994. Mor Mortal Wkly Rep, 1995; 44:1-13.

Botto LD, Moore CA, Khoury MJ, Erickson D. Neural tube defects. New Eng J Med, 1999; 341: 1478-1484.

Sadiq A. Les myéloméningocèles et les malformations associées. Thèse med casa, 1994. (Consulté le 06/01/2021).

Kabré A. Notre expérience du Spina bifida; à propos de 211cas; perspectives de prévention ; Université Cheikh Anta Diop de DAKAR; 1989; thèse de médecine n°73; 88 pages (Consulté le 06/01/2021).

Amadi CE. The pattern of distribution of encephalocele in University of Port Harcourt Teaching Hospital-a three year experience. Niger J Med. 2013 Jan-Mar ; 22(1):19-23.

Rabiou Maman S, Habou O, Adamou H, Amadou Magagi I, Magagi A, Maazou H. Caractéristiques épidémiologiques, cliniques et pronostiques des encéphalocèles opérées à l’Hôpital National de Zinder. Annales de l'Université Abdou Moumouni, 2016; 2: 48-54.

Sawadogo I. Spina bifida Aspects épidemiologique, clinique, thérapeutique et pronostic dans le service de neurochirurgie du CHUYO; A propos de 81 cas [Thèse]. Médecine humaine : Ouagadougou ; 2012; 107p.

Jauffret E. Spina bifida. EMC Kinésithérapie-Médecine physique Réadaptation, 26-472-B-10, 2006.

Elwood J M and McBride M L. Contrasting effects of maternal fertility and birth rank on the occurrence of neural tube defects Epidemiol Community Health. 1979 March; 33(1): 78–83.

Es Seddiki A, Messaouidi S, Amrani R. Le rôle du fenugrec dans la survenue d’anomalie de fermeture du tube neural : un signal d’alerte depuis le Maroc. Toxicologie. Phytothérapie (2017) 15:155-158.

Agrawal A and Sampley S. Spinal dysraphism: A challenge continued to be faced by neurosurgeons in developing countries. Asian J Neurosurg. 2014 Apr-Jun; 9(2): 68–71.

Mahapatra A. Spinal dysraphism controversies: AIIMS experiences and contribution. Indian J Neurosurg. 2012;1:4–8.

Kumar R, Singh SN. Spinal dysraphism: trends in northern India. Pediatr Neurosurg. 2003 Mar; 38 (3):133-45.

Sanoussi. S, Gamatie Y., Ikelan A., Sbai C., Abarchi H., Bazira L. Malformations du tube neural au Niger : à propos de 387 cas en 10 ans ; plaidoyer pour un traitement préventif par l’acide folique en période periconceptionnelle : Médecine d’Afrique Noire 2001 - 48 (12) P510-515.

Lorber J. Early results of selective treatment of spina bifida cystica British Medical Journal, 1973, 4, 201-204.

Sabiri N, Kabiri M, Razine R, Kharbach A, Berrada R, Barkat A. Facteurs de risque des malformations congénitales: étude prospective à la maternité Souissi de Rabat au Maroc. Journal de pédiatrie et de puériculture. 2013;26:198–203.

Mahapatra AK, Gupta DK. Split cord malformations: A clinical study of 254 patients and a proposal for a new clinical-imaging classification. J Neurosurg. 2005;103:531–6.

Kasliwal MK, Mahapatra AK. Surgery for spinal cord lipomas. Indian J Pediatr. 2007;74:357–62.

Kasliwal M, Dwarakanath S, Mahapatra A. Cervical meningomyelo cele-an institutional experience. Childs Nerv Syst. 2007;23:1291–3.

Greene ND, Stanier P, Copp AJ. Genetics of human neural tube defects. Hum Mol Genet. 2009;18:R113–29.

Laurence K, Tew B. Natural History of Spina Bifida Cystica and Cranium Bifidum Cysticum Major Central Nervous System Malformations in South Wales, Part IV. Arch Dis Child. 1971;46:127–38.

Zachary R. Ethical and social aspects of treatment of spina bifida. Lancet. 1968;2:274.

Nash DF. The Impact of Total Care with Special Reference to Myelodysplasia. Dev Med Child Neurol. 1970;12:1–11.

Toriello HV. Folic acid and neural tube defects. Genet Med. 2005;7:283–4.

Suarez L, Hendricks KA, Cooper SP, Sweeney AM, Hardy RJ, Larsen RD. Neural tube defects among Mexican Americans living on the US-Mexico border: Effects of folic acid and dietary folate. Am J Epidemiol. 2000;152:1017–23.

Berry RJ, Li Z, Erickson JD, Li S, Moore CA, Wang H, et al. Prevention of neural-tube defects with folic acid in China: China-U.S. Collaborative Project for Neural Tube Defect Prevention. N Engl J Med 1999; 341: 1485–1490.

Williams LJ, Mai CT, Edmonds LD, Shaw GM, Kirby RS, Hobbs CA, et al. Prevalence of spina bifida and anencephaly during the transition of mandatory folic acid fortification in the United States. Teratology 2002; 66: 33–39.

How to Cite
WF Rakotondraibe, RT Andrianaivo, MG Tsiaremby, S Raotoson, NH Raveloharimino, N Rabesandratana, D Andrianarimanana, & C Andriamamonjy. (2021). SPINA BIFIDA APERTA IN MAHAJANGA: CLINICAL CASES AND LITERATURE REVIEW . IJRDO -JOURNAL OF HEALTH SCIENCES AND NURSING, 6(1), 01-17. https://doi.org/10.53555/hsn.v6i1.4093