Long-term outcome and complications of children born with meningomyelocele

Abstract

The long-term functional outcome of 101 children born with meningomyelocele between 1971 and 1981 was assessed, by a combination of retrospective chart review and follow-up assessments. The children had been managed at birth using a process of nonstandardized selection. Eighty-three of the 101 patients survived after a minimum follow-up of 8.6 years, for a mortality rate of 18%. Forty-four of 83 children (53%) were community ambulators, and this correlated well with the presence of intact quadriceps function. Forty-eight children (58%) attended normal school and were grade-appropriate. Sixty-two of 83 patients (75%) were socially continent of urine, and 71/83 (86%) were socially continent of stool. Hydrocephalus was present in 93 of the 101 children in the study, and 85 children were shunted. Half of the shunted children required a shunt revision in the first year of life, and thereafter the rate of revision decreased, so that after 2 years the risk of revision was approximately 10% per year.

Expectation of life and unexpected death in open spina bifida: a 40‐year complete, non‐selective, longitudinal cohort study

“…7,12,13,21 Although this was a small cohort, it is similar in size to other studies. 10,11 Finally, our findings may not be applicable to non-white ethnic groups or to countries with higher prevalences of spina bifida or different systems of medical care. However, our data may serve as a baseline with which to compare the results of other series.…”

“…The main limitation is that treatment has improved greatly in the four decades since the study began. 8,11,13 The high mortality before the age of 5 years is typical of the outcome in the period 1963 to 1975. 4,5,9 Improvements in treatment have resulted in reduced mortality in childhood, 12,13 and ventriculoperitoneal shunting has reduced shunt-related death rates.…”

“…4 Neurosurgical intervention increased survival at 1 year from 20% to 80%, but noone knew what the long-term outcome would be, and, as the children grew older, their physical and intellectual disabilities became more evident. [5][6][7] Although there have been many reviews of outcome in children and young adults with spina bifida [8][9][10][11][12][13] data from long-term reviews are sparse and incomplete. In three studies, the maximum age of survivors was less than 25 years, [10][11][12] and in one cohort 20% were lost to follow-up.…”

“…[5][6][7] Although there have been many reviews of outcome in children and young adults with spina bifida [8][9][10][11][12][13] data from long-term reviews are sparse and incomplete. In three studies, the maximum age of survivors was less than 25 years, [10][11][12] and in one cohort 20% were lost to follow-up. 10 It has been widely suggested that, after the initial hazardous years, survival in spina bifida is near normal, [14][15][16] but there is no empirical evidence to support this.…”

Role of helical CT and MRI in the evaluation of spinal dysraphism

“…To characterize the lesion Helical CT and MRI are very much helpful. 1 Spinal dysraphism are mainly divided into open spinal dysraphisms in which there is exposure of neural elements to exterior through a defect in skin and closed spinal dysraphisms in which there is skin coverage to underlying spinal malformation. [2][3][4][5][6][7][8][9] This study depicting the various imaging features of Spinal dysraphism and the importance of Helical CT and MRI in the evaluation of Spinal dysraphism.…”