Meningomyelocele: A New or a Vanishing Disease?*

Abstract

I believe meningomyelocele is not vanishing, but is a new and diminishing disorder. Prenatal diagnosis will be accepted only by a portion of most communities if abortion is the only alternative to the delivery of an impaired child. I believe participation in neural tube screening programmes can be increased by offering improved pregnancy outcome with concomitant prelabor caesarean section in addition to termination. Regardless, the prevalence at birth of children with myelomeningocele will decrease both in total numbers and in the severity of the expressed lesion. The resultant rarity will require collaboration between centers to evaluate treatment. The developing International Myelodysplasia Study Group using a Patient Data Management System and computer-assisted analysis is a model of successful collaboration that allows better exploration of the multiple variables that contribute to the well-being of children with open neural tube defects of the spine.

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

“…The current era of markedly improved survival and reduced morbidity for patients born with Myelomeningocele followed the introduction of relatively effective cerebrospinal fluid shunt systems in the forty-eight years following the introduction of Holter's original cerebrospinal fluid shunt (42). In addition, during this era of improved neonatal care, effective broader spectrum antibiotics and non-invasive nervous system diagnostic techniques including MRI, ultrasound and er scans further reduced morbidity and mortality (53).…”

Urologische Langzeitbetreuung von Patienten mit Meningomyelozele I. Diagnostik

“…Die Betreuung von Kindern mit MMC muß interdisziplinär in einem Team aus pädiatrischem Nephrologen, Neuropädiater, Orthopäden, Neurochirurgen und Urologen erfolgen, um die Lebensqualität der Betroffenen und ihre Integration in die Gesellschaft zu optimieren. Mit diesem Konzept überlebten in den 80er Jahren bereits 65 % sämtlicher Spina-bifida-Kinder die ersten 15 Lebensjahre (36).…”