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Late follow-up in spina bifida cystica
Insights
Survivors of spina bifida cystica born between 1960-66 showed varying outcomes. Infants with myelomeningocele and exposed spinal cords faced higher mortality and handicap rates compared to those with ectopic nervous tissue.
Area of Science:
- Pediatric Surgery
- Developmental Neurology
- Clinical Pediatrics
Background:
- Spina bifida cystica is a congenital condition affecting neural tube development.
- Long-term outcomes for infants born with spina bifida require ongoing evaluation.
- Previous studies highlight the variability in prognosis based on lesion type.
Purpose of the Study:
- To describe the 1969 progress of survivors from a 1960-66 cohort of 150 babies with spina bifida cystica.
- To analyze the outcomes of different myelomeningocele presentations.
- To discuss the management of associated hydrocephalus and evolving treatment attitudes.
Main Methods:
- Longitudinal follow-up of 150 infants born with spina bifida cystica (1960-66).
- Categorization of myelomeningocele cases into groups based on spinal cord presentation (plaque vs. ectopic tissue).
- Assessment of survival rates, handicap incidence, and hydrocephalus management.
Main Results:
- Children with meningocele had favorable outcomes.
- Myelomeningocele group with exposed spinal cord (n=23) had 4 late deaths and significant handicap.
- Myelomeningocele group with ectopic nervous tissue (n=25) had 2 late deaths and lower handicap rates.
- Incidence and treatment of hydrocephalus were documented.
Conclusions:
- The presentation of myelomeningocele significantly impacts long-term prognosis.
- Babies with ectopic nervous tissue in the sac show better outcomes than those with exposed spinal cords.
- Treatment approaches for neonates with myelomeningocele have evolved.
Abstract:
The further progress of the survivors in 1969, of a group of 150 babies born with spina bifida cystica in the period 1960-66 is described. Children with a meningocele continued to do well. Those with a myelomeningocele are divided into 2 groups. There were 4 late deaths and a considerable degree of handicap in the group of 23 in whom the spinal cord was exposed on the surface as a plaque at birth. There were 2 late deaths and a much lower incidence of handicap in the group of 25 in whom only ectopic nervous tissue was found in the sac at birth. The incidence and treatment of hydrocephalus is described. Changes in the attitude to the treatment of a neonate with a myelomeningocele are discussed.