From the Guidelines
A 12-year-old with spina bifida typically requires ongoing comprehensive follow-up rather than a single "further workup" to monitor for complications related to their condition and prevent serious secondary conditions. These patients need regular multidisciplinary care, including urological evaluation with renal ultrasound and urodynamic studies every 1-2 years to monitor for neurogenic bladder dysfunction and prevent renal damage, as highlighted in studies such as 1 and 1. Key assessments should also include:
- Orthopedic assessment to evaluate for scoliosis, joint contractures, and mobility issues
- Neurological monitoring to focus on signs of tethered cord syndrome or hydrocephalus if a shunt is present
- Regular developmental and psychological evaluations as the child approaches adolescence
- Bowel management programs should be assessed for effectiveness, and nutritional status monitored due to increased risk of obesity or undernutrition The specific workup needed depends on the individual's level of lesion, existing complications, and functional status, as noted in 1. This comprehensive approach is essential because spina bifida affects multiple body systems, and early detection of complications can significantly improve quality of life and prevent serious secondary conditions.
From the Research
Spina Bifida in 12-Year-Olds
- A 12-year-old with Spina bifida may require further workup to assess and manage any potential complications associated with the condition 2, 3.
- The need for further workup depends on various factors, including the type and severity of Spina bifida, the presence of any symptoms or complications, and the individual's overall health and well-being.
Uroneurological Assessment
- A uroneurological assessment, including a neurological examination, urinary questionnaire, and urodynamic studies, can help diagnose and manage Spina bifida-related disorders 2.
- This assessment can identify potential issues, such as urinary incontinence, enuresis, and bladder abnormalities, which are common in individuals with Spina bifida 2, 4.
Management and Care
- Close evaluation and intervention during the newborn period and toddler years are crucial to prevent renal deterioration and promote normal renal development in children with Spina bifida 3.
- As children with Spina bifida age, attention should be directed to quality-of-life issues, such as establishing urinary and bowel continence, and teenagers should begin to assume responsibility for their own care 3.
- The relationship between continence status and quality of life in young children with Spina bifida is complex, and additional research is needed to further evaluate condition-specific variables and other factors that influence quality of life 5.