The results of a selective surgical policy on the cognitive abilities of children with spina bifida.

A cohort of spina-bifida children born between 1973 and 1978 and subjected to selection for surgery was divided into those who met specific physical criteria at birth and were offered immediate treatment, and those who had delayed treatment because of adverse criteria. There was a significantly higher level of intelligence among children treated immediately but a fifth of those given delayed treatment had normal levels of intelligence. There were negligible differences in intelligence between the children given delayed treatment and an unselectively treated series of children born between 1964 and 1966, suggesting that postponing surgery for a period does not necessarily have a disastrous effect upon ability.