[Spina bifida: management after 25 years].

The authors present their experience of 468 patients with spina bifida treated in a period of 25 years. They discuss the philosophy of the management of the severe neural tube defects based in the follow up of these patients. This attitude is based in the prevention that could be: 1) following Smithells theory; 2) trying a prenatal diagnostic before 20 weeks of pregnancy, and 3) doing a selection of spina bifida that could be operated.