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Related Experiment Videos

Spina bifida outcome: a 25-year prospective.

R M Bowman1, D G McLone, J A Grant

  • 1Division of Pediatric Neurosurgery, Children's Memorial Hospital, Northwestern University Medical School, Chicago, IL 60614, USA. r-bowman@nwu.edu

Pediatric Neurosurgery
|May 19, 2001
PubMed
Summary

Long-term survival for open spina bifida (myelomeningocele) patients is over 75% into adulthood, but late complications are frequent. Establishing adult care networks is crucial for managing these complex congenital conditions.

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Area of Science:

  • Neurology
  • Pediatric Surgery
  • Developmental Biology

Background:

  • Open spina bifida, specifically myelomeningocele, represents a significant congenital abnormality with long-term survival implications.
  • This study examines the long-term outcomes of a cohort of myelomeningocele patients treated prospectively.

Purpose of the Study:

  • To evaluate the 20- to 25-year outcomes in patients with myelomeningocele.
  • To identify common complications and functional status in young adults with spina bifida.

Main Methods:

  • A prospective cohort of 118 myelomeningocele patients was reviewed.
  • Seventy-one patients were available for follow-up, with data collected on motor level, shunt status, education, mobility, continence, and surgical interventions.
  • Mortality and complication rates were analyzed over a 20-25 year period.

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Main Results:

  • Mortality reached 24% by young adulthood, with 86% requiring cerebrospinal fluid diversion (95% shunt revisions).
  • Tethered cord release (32%) improved symptoms in 97%, while 49% developed scoliosis (43% requiring fusion).
  • 23% experienced seizures, 85% achieved high school/college education, and over 80% had social bladder continence. Latex allergy affected ~33%.

Conclusions:

  • Over 75% of children with myelomeningocele survive into early adulthood.
  • Late deterioration and complications are common, necessitating ongoing monitoring.
  • Developing specialized care networks for adults with spina bifida is a critical unmet need.