Patient selection: open spina bifida, surgically closed soon after birth
Patient assessment: complete neurologic examination during infancy
Criteria for perineal sensation - all of the following:
(1) intact sensation to pinprick in >= 1 dermatome
(2) on one or both sides
(3) in the saddle area (S2 to S4)
Adverse outcomes that are more common in patients lacking any perineal sensation:
(1) renal death (see below)
(2) incontinence of urine and/or feces
(3) inability to walk at least 50 meters
(4) pressure sores
Patient at risk for renal death - both of the following:
(1) bilateral, symmetrical neurological deficit at or above L3
(2) absence of perineal sensation
