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J Pediatr Rehabil Med. 2010;3(3):177-85. doi: 10.3233/PRM-2010-0127.

Outpatient medical conditions among children and adults with spina bifida in the United States: Frequency and expenditures.

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National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.



To describe the most prevalent conditions and their associated expenditures for the outpatient care of individuals with spina bifida (SB) of varying ages.


From a large health insurance claims database of people with private insurance, we examined records on outpatient health care received during 2005-2006 for individuals with SB and a matched comparison group. Chronic conditions from the most frequently recorded 4-digit ICD-9-CM codes for individuals with SB were grouped into four categories: cardiovascular disease risk factors, SB secondary conditions, pain, and other symptoms.


Diseases affecting the nervous, genitourinary, and musculoskeletal systems and miscellaneous symptoms (e.g., headache, fever) account for about 70% of outpatient expenditures, excluding those associated with perinatal and congenital conditions. The most common and costly conditions by age group were diseases of the nervous system for children and adults younger than age 30 years and diseases of the musculoskeletal system for adults aged 30-64 years. Individuals with SB had significantly elevated risks for essential hypertension, urinary tract infection, and constipation at young ages and headache, sleep disturbance, and fever throughout the life span.


The frequency of health conditions associated with SB varies across the life span. These conditions should be a priority for further investigations to identify risk factors, treatment and prevention strategies for individuals with SB.

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