Hunt G, Lewin W, Gleave J, Gairdner D
Br Med J. 1973 Oct 27;4(5886):197-201. doi: 10.1136/bmj.4.5886.197.
A total of 113 cases of open myelomeningocele operated on shortly after birth were followed up and the 80 survivors (71%) were assessed one and a quarter to seven and a half years later. Their disability was classified in terms of mobility, intelligence, continence, and major complications; these when combined provided an assessment of overall disability. The overall disability of the survivors was minimal in 6%, moderate in 40%, severe in 39%, and very severe in 15%.A number of clinical features present at birth were analysed for their predictive value. Of these the sensory level, which frequently differed from both external and radiological levels of the lesion, correlated with the outcome in terms of mobility, intelligence, continence, major complications, and overall disability; and also with deaths caused by renal failure.A policy of confining operation to those patients with a reasonable chance of achieving independence would involve selecting for treatment a minority of all infants born with open myelomeningocele.
对113例出生后不久即接受开放性脊髓脊膜膨出手术的病例进行了随访，80名幸存者（71%）在1年零3个月至7年半后接受了评估。根据行动能力、智力、大小便控制能力和主要并发症对他们的残疾情况进行了分类；这些因素综合起来可对总体残疾情况进行评估。幸存者的总体残疾情况为：轻度占6%，中度占40%，重度占39%，极重度占15%。对出生时出现的一些临床特征的预测价值进行了分析。其中，感觉平面（常常与病变的体表和放射学平面不同）在行动能力、智力、大小便控制能力、主要并发症和总体残疾情况方面与预后相关；也与肾衰竭导致的死亡相关。将手术限于那些有合理机会实现自理的患者的政策，意味着在所有患有开放性脊髓脊膜膨出的婴儿中，只有少数会被选来接受治疗。
