Prognosis of SB

The prognosis for people with SB varies, but depends mainly on the severity of the condition (and the associated complications). Prognosis is obviously better for patients with occulta (the mildest form of SB), and worse for patients with myelomeningocele.

The children with poor prognosis ar those who are completely paralysed, have serious infection of the spinal cord, have hyrocephalus or other birth defects.

Level of the lesion also affects prognosis, for obvious reasons, Long-term survival is dependent on adherence to appropriate bowel and bladder regimens and careful management of urinary complications to prevent renal failure.

With proper care most children with SB live well into adulthood, also improved surgical procedures have improved prognosis – e.g. (experimental, i think) prenatal fetal surgery which involves sewing up/closing the shunt/opening in the fetus spinal cord has been associated with a decreased risk for Chiari II (whereby the brain stem and cerebellum protude in the spinal canal) – hence less/no hydrocephalus.

According to :

In a UK-based survey of Spina Bifida patients born between 1963 and 1971 and surveyed 20 years later:

  • 50% had died (largely the most severely disabled)
  • 84% of survivors required CSF shunting
  • 70% had an IQ>80
  • 37% lived independently in the community
  • 39% drove a car
  • 30% could walk >50 m
  • 26% in open employment
  • One-third needed daily care
  • A minority of patients had severe dependency/disability – need for respiratory support, blindness and dialysis-dependence
  • Those who had a need for CSF-shunt revision had worse outcomes in terms of attainment and independence

~ by pcl4 on October 16, 2008.

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