Delayed Presentation of Meningomyelocele in a Tertiary Care hospital of Northern India

Meningomyelocele (MMC) is a severe congenital defect of the central nervous system resulting from incomplete closure of the neural tube during embryogenesis. The reported incidence of MMC in India is approximately 3.9 per 1000 live births (range: 3.6 to 7.48), which is significantly higher than that in developed countries- almost three times greater. Early surgical intervention is critical to reduce complications such as cerebrospinal fluid (CSF) leakage, local infection, bleeding, delayed wound healing, and recurrent tethering of the spinal cord. Unfortunately, due to limited awareness and inadequate healthcare infrastructure, particularly in remote regions, many patients present late and receive suboptimal initial care. In this prospective observational study conducted over 2.5 years at a tertiary care center, we aimed to evaluate the non-neurological sequelae associated with delayed MMC repair. A total of 105 patients were included, comprising 77 males and 28 females, with a mean age at presentation of 1.07 years. The most frequent site of lesion was the lumbosacral region. Postoperative follow-up revealed that wound infection was the most commonly encountered complication. Our findings highlight that delayed presentation of MMC is associated with technically challenging surgeries and a higher incidence of postoperative complications. These observations underscore the need for increased public health awareness, timely diagnosis, and early referral to specialized centers to improve outcomes in affected patients.