Spinal Cord Dysfunction
Spina bifida (SB) and spinal cord injuries (SCIs) are the most common etiologies for spinal cord dysfunction (SCD) in childhood, although infectious, rheuma- tologic, demyelinating, and tumor etiologies are also seen.
The incidence and prevalence of SCD in general is low in a pediatric population. Earlier chapters have identified the decreasing incidence of both SCI and SB. The prevalence for both, and for SCD in general, are only estimates, and are well below estimates for intellectual disabilities (ID) and CP. It is also estimated that life expectancy is increasing, and therefore, it is important to understand the lifelong health and functional issues of adults with childhood-onset SCD. SCD usually involves multiple organ systems at a high level; these medical conditions are fairly well described; and consequently, there may be more medical monitoring than in other conditions. There is significant overlap in the long-term management of those with SCI and SB, although there are disability-specific health issues and risks. This section will highlight what is known about the health of adults with childhood-onset SCI and SB independently. For both subsets, adults are presenting with health challenges, such as renal dysfunction, musculoskeletal problems, neurologic complications, pulmonary conditions, pressure ulcers, and sexuality and reproduction issues (see Table 15.2).
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