Myelomeningocele and Tethered Cord: Caring for an Aging Population

Neurosurgeons outside pediatric centers are sometimes called upon to treat patients with spinal dysraphism. Children with spinal dysraphism are living longer. Upon entering adulthood they often become ineligible for care in pediatric facilities having a robust resource base focused on management of this complex multiorgan-system disease. Additionally, a percentage of patients will present in adulthood with spinal cord tethering of various etiologies. There is very limited data to recommend that adults should be followed in a multidisciplinary spina bifida clinic. There is even less data to suggest whether this care should be provided in the adult or the pediatric setting. We will discuss the pediatric model and its implications relevant to adults with spinal dysraphism. We feel that adults with complex spinal dysraphism should be followed in a multidisciplinary spina bifida clinic.