Spina Bifida Outcome: A 25-Year ProspectiveBowman R.M. · McLone D.G. · Grant J.A. · Tomita T. · Ito J.A.
Division of Pediatric Neurosurgery, Children’s Memorial Hospital, Northwestern University Medical School, Chicago, Ill., USA
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.
© 2001 S. Karger AG, Basel
Robin M. Bowman, MD
Children’s Memorial Hospital
2300 Children’s Plaza #28
Chicago, IL 60614 (USA)
Tel. +1 773 880 4373, Fax +1 773 880 4311, E-Mail firstname.lastname@example.org
Received: Received: November 16, 2000
Accepted: January 8, 2001
Number of Print Pages : 7
Number of Figures : 4, Number of Tables : 1, Number of References : 21
Founded 1985 by E.B. Hendrick and D.H. Reigel; Editor-in-Chief 1992–1996: F.J. Epstein
Official Journal of the American Society of Pediatric Neurosurgeons (ASPN)
Vol. 34, No. 3, Year 2001 (Cover Date: March 2001)
Journal Editor: D.G. McLone, Chicago, Ill.
ISSN: 1016–2291 (print), 1423–0305 (Online)
For additional information: http://www.karger.com/journals/pne