Early, aggressive care of myelomenigocele has now improved the overall prognosis associated with this condition. Prognosis varies with the degree of neurologic deficit. The child’s motor abilities vary according to the level of the lesion. Delays in motor function (including walking) can be expected in all children with this type of problem.
At present, prognosis is poorest for children who have total paralysis below the lesion. The presence of other problems such as kyphoscoliosis (curvature of the spine) and hydrocephalus (increased fluid in the brain) are common.
Overall developmental delays occur less often as a result of improved medical treatment for these children. Physical and occupational therapy from an early age on help children with this condition to advance their skills and improve function.
A child’s ability to walk outdoors and use a wheelchair by age seven usually suggests a good prognosis for ambulation (walking). If functional ambulation is not present by age seven to nine, it is unlikely to occur later.
A third of all people with myelomeningocele demonstrate a decline in ambulatory status with increasing age, usually around age 12. These losses are often linked with changes that occur during the teen years. For example, increasing body size, loss of strength, or immobilization after surgery or fracture can affect the ability to regain independent ambulation.
As the child matures into adulthood, motor function and balance tend to decline. Many lose the ability to remain independent in ambulation over time.