Overview of Care At birth, the child should be seen by an experienced neurologist, with consultation by a neurosurgeon,orthopaedic surgeon and urologist. General Measures Monitor motor strength and sensory level and record throughout life in order to detect tethering or other complication. Teach family how to protect insensate skin. Involve in a support group such as Spina Bifida Association of America. Complications Shunt failure Cord tether at site of opening, causing weakness with growth.
Fracture- risk is higher with higher neurologic deficit.
Signs include low-grade fever, swelling, and warmth without much pain. Pressure sore over insensate skin, especially of ischium, foot or trochanter. Renal failure due to poor self-care. Prognosis Infant mortality is only slightly increased now due to excellent neonatal care. Long term independence is not possible in some individuals impaired by CNS complications.