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Open spina bifida: birth findings predict long-term outcome.

OBJECTIVES: To investigate if lifestyle in spina bifida at age 40±3 years, relates to neurological deficit in infancy or cerebrospinal fluid shunt history.

DESIGN: Prospective cohort study with 100% ascertainment.

SETTING: Community.

PARTICIPANTS: 117 consecutive cases of open spina bifida whose backs were closed non-selectively at birth. In 2007, all 46 (39%) survivors and/or carers were surveyed by postal questionnaires and telephone interviews.

RESULTS: Of the 38 children with absent sensation only below the knee (sensory level below L3), 23 (61%) survived of whom 14 (61%) were community walkers and only 5 (22%) needed daily care. But in 42 babies with absent sensation up to the umbilicus (sensory level above T11) only seven (17%) survived, none could walk and five (71%) needed daily care. Survivors with no shunt revisions were more likely to walk, live independently and drive a car.

CONCLUSION: Mobility and the need for care at 40 can be predicted from the neurological deficit.

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