Spina bifida: a new disease

The paper by Wald entitled "Biofeedback in the Treatment of Fecal Incontinence in Patients with Myelomeningocele" (Pediatrics 68:45, 1981) represents an additional small, but significant step in the management of children with spina bifida. In the 1950s most children with spina bifida were left to die. In the 1960s most were vigorously treated. In the early 1970s Dr John Lorber presented a retrospective analysis of his results, and published his criteria for selection.1 Over these three decades the approach to the newborn with spina bifida has swung like a pendulum. More recent series2,3 demonstrate that with early treatment more than 80% of children survive; in our experience more than 95% survive.