Selection of appropriate treatment for patients with myelomeningocele

Patients with myelomeningocele are limited in their eventual adult habilitation by the level of their lesion. Patients with high level lesions are not only limited in their motor skills but tend to have an increased number of central nervous system abnormalities in relationship to the height of their level of paralysis. These disabilities require more treatment and training, and the patient's time should not be occupied by unnecessary treatment or training that will not be utilized in adulthood. Exhaustive treatment for ambulation should not be utilized in potentially nonambulatory patients. Early prognostic indicators are utilized and treatment is based on the patient's potentials. Teaching and practice of the skills needed in adulthood along with motivation impetus must be carried out in the young child if the skills are to be successfully used in adulthood.