Care of the Adolescent with Spina Bifida

Myelodysplasia with attendant spinal dysraphic disorders can be and often is progressive. In addition to the neurologic deficit present since the prenatal period, hydrocephalus, Chiari malformations with hydromyelia, tethered cord syndrome, or combinations of one or all lead to changing functional ability and progressive deformities. With recent advances in neurologic monitoring and treatment, many of these deformities can be prevented from appearing or becoming destabilizing if the subtle signs are picked up and early intervention is provided. Advances in urologic surgery have also provided better control of continence in addition to reduced infections and renal destruction. This article reviews the monitoring and treatment considerations that have led to such a significant improvement in outcomes in patients who have myelodysplasia.