A Controlled Trial of Immediate and Delayed Closure of Spina Bifida Cystica

Spina bifida cystica.

Studies in Spina Bifida Cystica

Nicolai Tulp, the physician whose features are immortalized in Rembrandt's painting 'The School of Anatomy', first suggested the name 'spina bifida' (Tulpius, 1652), though the condition was known to Hippocrates, and the mediaeval Arab physicians are said (Denuce, 1906) to have specifically recognized the absence of the spinous processes in the affected area. Ruysch (1691) distinguished between...

The Family History of Spina Bifida Cystica.

589 T HIS STUDY iS conceriled with the family history of 722 infants who were horn with spina bifida cystica (meningomyelocele, myelocele and meningocele) and who were referred to the Children’s Hospital, Sheffield, for surgical treatment. No cases were excluded from this investigation. None of the infants or children were referred for genetic advice hecautse of special problems, and if there w...

A controlled trial of immediate and delayed closure of myelomeningocele.

Sharrard, Zachary, Lorber and Bruce (1963) in a study offorty children with spina bifida cystica, eighteen of whom survived three months, concluded that “operative closure of myelomeningocele should be regarded as a surgical emergency”. They believed that it was ethically unjustifiable to continue their controlled trial of treatment. Following this paper there was a wide acceptance of early clo...

Selection for treatment in spina bifida cystica.

This paper discusses (1) the mortality in 295 patients with myelomeningocele born 1961-9, (2) the "quality of life" of 88 surviving patients born 1961-5, and (3) their implications for selection for treatment in spina bifida cystica. Evidence is presented that high neurological levels, the presence of severe hydrocephalus, especially if present at birth, meningitis and ventriculitis, and gross ...