[Physical and mental development after early surgery of myeloceles].

These investigations are based on 143 myelocele operations (=93 % spina bifida cystica), with a follow-up period of 3-15 years. There was an associated hydrocephalus in 88%. In 114 (89%) of the children with hydrocephalus a ventriculo-atrial shunt was inserted. In three quarters of the cases this was done within the first three months of life. In general the chindren remained "shunt-dependent" and only in 9% was it possible to remove it later. Of the surviving children about 25% were restricted to a wheel-chair and of them 7% had severe mental defects. Their physical state as regards head growth,height and weight showed about 70% of average values. Neurogenic disturbances of bladder emptying were present in 90% of the children. The expectation of survival to age 13 was 65%. Using the Hamburg Wechsler Intelligence Test for Children (Hawik) the intellectual development showed an average of 97 +/- 15-219 With only a trifling deviation this corresponds to the normal mean. The Bühler-Hetzer test also showed normal values in 70%. All the children are able to receive some training, which ranged from special schools right up to grammar school. We have particularly gone into the problem of the social rehabilitation of these children.