Spina bifida outcome: A 25-year prospective

Robin Bowman*, David G McLone, John A. Grant, Tadanori Tomita, Joy A. Ito

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

470 Scopus citations

Abstract

Background: Open spina bifida is the most complex congenital abnormality compatible with long-term survival. This report outlines the 20- to 25-year outcome for our original cohort of patients with a myelomeningocele treated in a nonselective, prospective manner. Methods: Of the initial 118 children, 71 patients were available for our most recent review. Nineteen patients have been lost to follow-up and 28 patients have died. Data were collected on: motor level, shunt status, education/employment, seizure history, mobility, bladder/bowel continence, tethered cord, scoliosis, latex allergy, posterior cervical decompression, tracheostomy and/or gastrostomy tube. Results: Mortality (24%) continues to climb into young adulthood. Eighty-six percent of the cohort have cerebrospinal fluid diversion, with 95% having undergone at least one shunt revision. Thirty-two percent have undergone a tethered cord release, with 97% having an improvement or stabilization in their preoperative symptoms. Forty-nine percent have scoliosis, with 43% eventually requiring a spinal fusion. Sixteen patients (23%) have had at least one seizure. Eighty-five percent are attending or have graduated from high school and/or college. More than 80% of young adults have social bladder continence. Approximately 1/3 of patients are allergic to latex, with 6 patients having experienced a life-threatening reaction. Conclusion: At least 75% of children born with a myelomeningocele can be expected to reach their early adult years. Late deterioration is common. One of the greatest challenges in medicine today is establishing a network of care for these adults with spina bifida.

Original languageEnglish (US)
Pages (from-to)114-120
Number of pages7
JournalPediatric neurosurgery
Volume34
Issue number3
DOIs
StatePublished - Mar 1 2001

Keywords

  • Myelodysplasia
  • Spina bifida
  • Tethered cord

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Spina bifida outcome: A 25-year prospective'. Together they form a unique fingerprint.

Cite this