44 Years Experience with Management of Myelomeningocele: Presidential Address, Society for Research into Hydrocephalus and Spina Bifida

The relationship of neuropsychological functioning to adaptation outcome in adolescents with spina bifida

“…Neurological severity indices of SB, such as level of lesion, shunted hydrocephalus, shunt infections, shunt revisions, and presence of epilepsy are important predictors of adaptation outcomes (Barf et al, 2003;Bergsten & Lagergren, 1990;Duquette, 1997;Fletcher et al, 2005;Iddon et al, 2004;Kim, 1991;Larsson, 1995;Matson et al, 2005;Pless, 1984;Shurtleff, 2000;Wallander & Thompson, 1995;Wallander & Varni, 1995;Wolman et al, 1994;Zurmohle et al, 1998). Level of lesion affects the quality and severity of motor and sensory impairment (Galli et al, 2002).…”

Pediatric perspective on prenatal counseling for myelomeningocele

“…let the surgeons not unprudently open such a swelling, but force them to see the shame this would undoubtedly bring upon themselves.'' Despite various types of treatment over the next 300 years, most patients died from infection (putrefaction) until the introduction of aseptic surgery in the late 1800s (Shurtleff, 1986b(Shurtleff, , 2000. Bayer (1897) introduced aseptic closure of myelomeningocele immediately after birth.…”

Descriptive analysis of 258 emergency department visits by spina bifida patients

“…Spina bifida has been associated with neurologic, urologic, orthopedic, and dermatologic sequelae ( 1,7,10,12,14,16). Study patients were frequently diagnosed with these complications (Tables 2 and 3 ).…”

“…Long-term survival has been dramatically improved by advances in medical and surgical management such as early closure of the spinal cord defect, the use of intraventricular shunts to prevent hydrocephalus, improved management of genitourinary complications, and improved orthopedic techniques. Today, 90% of patients with spina bifida survive infancy (1,(7)(8)(9)(10)(11). Due to its relatively high prevalence and to improved patient survival, there now exists a significant spina bifida population in the United States.…”

“…Spina bifida is associated with a variety of characteristic complications secondary to spinal cord dysfunction at levels below the lesion (1,2,7,(12)(13)(14)(15)(16)(17). Complications include infectious, neurologic, orthopedic, genitourinary, and dermatologic sequelae.…”