OPEN SPINA-BIFIDA - A COMPLETE COHORT REVIEWED 25 YEARS AFTER CLOSURE

This study summarises the long-term results of non-selective treatment of open spina bifida. Every member of a consecutive series of 117 cas es was ascertained 22 to 28 years after closure of the back. 56 of the cohort had died. The condition of the 61 survivors ranged from normal to severe disability. Only 33 of the survivors were capable of living independently, 11 required supervision and some help, and 17 needed d aily care which was generally provided by the parents. The two main de terminants of disability and dependency were the extent of the neurolo gical deficit and IQ. Improvements in the management of patients with open spina bifida have greatly reduced mortality, but they are less li kely to influence long-term disability since that is dependent on the severity of the neurological deficit.