Caudal Dysplasia Health Article

Delivery management

Because of the abnormalities seen and the possible complications, delivery should be at a tertiary care center or hospital able to provide specialized pediatric care. It is likely that an infant with caudal dysplasia will spend a significant amount of time in the hospital as a newborn. If the tertiary care center is not located near the family, this can increase the burden of care for the family.

There is no cure for caudal dysplasia. Treatment is governed by the abnormalities present. If the abnormalities are severe (life-threatening), corrective surgery is not an option. The main goals of treatments include maintaining and improving kidney, lung, and gastrointestinal function. Orthopedic surgeries are done to correct malformation, and physical therapy is used to avoid secondary complications, such as scoliosis.

Many of the defects of caudal dysplasia can be surgically treated but not cured. For example, an opening on the spine (spina bifida) can be surgically closed, but if the nerves in that opening have been damaged, there is nothing that can be done to reverse this damage. Other surgeries include orthopedic surgeries to correct bone malformations and improve limb function. Surgery can also be done to correct hydrocephalus or imperforate anus.

Other treatments involve orthopedic devices and treatments for neurogenic bladder. Orthopedic devices may be used to help with problems of the hip, back, and legs. Neurogenic bladder is one of the more serious and debilitating problems in caudal dysplasia. Long-term bladder dysfunction can result in kidney damage and failure.

The treatments for caudal dysplasia often require lifelong medical attention. It is important to prepare the family for this and to stress the need for preventative care (i.e., prevention of infections) and vigilance in detecting complications.

Prognosis

The prognosis for caudal dysplasia is highly dependant on the severity of the malformation present. Those with extremely mild abnormalities may have no or few symptoms. Infants with more serious symptoms may require extensive urologic and orthopedic assistance, including multiple surgeries and lifelong therapies. Neurogenic bladder is one of the more serious and debilitating problems in caudal dysplasia. Long-term bladder dysfunction can result is kidney damage and failure, and intensive efforts may be required to avoid this problem. Some infants with caudal dysplasia are born with lethal abnormalities that are incompatible with life. Infants that do survive generally have normal mental function.

WEB SITES

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (April 8, 2005.) <http://www.nih.gov/niams>.

ORGANIZATIONS

National Institute of Arthritis and Musculoskeletal and Skin Diseases. 1 AMS Circle, Bethesda, MD 20892-3675. Telephone: (301) 496-8188. Fax: (877) 226-4267. E-mail: NAMSIC@mail.nih.gov. (April 8, 2005.) <http://www.nih.gov/niams>.

Kathleen A. Fergus, MS, CGC