From 1977 to the present, we have managed 30 patients with spina bifida occulta associated with a low-placed conus medullaris. Twenty-six patients had surgery performed. Nineteen patients demonstrated urological and neurological improvement. The characteristics of this condition include a cleft spine revealed by plain x-ray, vesicorectal disturbances, local findings (such as a tumor, dimpling, and angioma in the lumbosacral region), and deformities of the feet. Surgery is indicated after confirmation of neurological symptoms, such as a vesicorectal disturbance, after about 1 year of age or older. Operation is not needed immediately after birth.
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Nakamura et al. (1988) studied this question.