Long-term outcome and complications of children born with meningomyelocele.
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.
Steinbok
P
P
Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Irvine
B
B
Cochrane
D D
DD
Irwin
B J
BJ
D000203:Activities of Daily Living; D000293:Adolescent; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006849:Hydrocephalus / Q000401:mortality / Q000601:surgery; D008124:Locomotion; D008297:Male; D008591:Meningomyelocele / Q000401:mortality / Q000601:surgery*; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate