Multidisciplinary spina bifida clinic brings specialists together each month

Since 2016, the Norton Children’s Spina Bifida Clinic has provided a multidisciplinary care model allowing for multiple opinions to arrive at an optimal care plan.

On the third Wednesday of each month, a team of specialists from across Norton Children’s come together to provide multidisciplinary care to kids with spina bifida (SB).

Since 2016, the Norton Children’s Spina Bifida Clinic — in coordination with the Kentucky Office for Children with Special Health Care Needs — has provided a care model that allows these children to receive all their care at the same time. In addition to one-stop care, this allows for the many care givers to communicate in real time and develop an optimal care plan.

At the clinic, patients have access to neurosurgeons, orthopedic surgeons, spine surgeons, urologists, gynecologists, physical therapists, occupational therapists, rehabilitation specialists and social services. Families can connect with nutrition consultants and support services from the Spina Bifida Association of Kentucky.

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“The SB clinic came together because Norton Children’s realized that this was the right thing to do for the patients,” said Ian S. Mutchnick, M.D., a pediatric neurosurgeon with Norton Children’s Neuroscience Institute and part of the neurosurgical team that staffs the clinic.

In addition to existing patients, the clinic takes on about 10 new patients a year. Patients with different types of spina bifida can all receive care at the clinic – those with myelomeningoceles, closed neural tube defect and meningoceles

Due to the complex nature of the condition, patients may require treatments ranging from orthopedic and bladder surgeries to education plans for learning issues.

Nearly 80% of myelomeningocele patients at Norton Children’s need cerebrospinal fluid shunts. Procedures to place the shunts involve neurosurgeons and plastic surgeons – these can also be followed by neurosurgery in the Norton Children’s Spina Bifida Clinic.

Therapists also play a big role in caring for spina bifida patients. “Therapists should be a part of every patient’s care since they are often the first to notice a decline in function mandating a tethered cord release,” said Dr. Mutchnick. “A patient should see a physical therapist every three to six months in case there are subtle declines in function.”

While fetal MRIs can give some indication of a spina bifida prognosis, Dr. Mutchnick encourages providers to wait on discussing the prognosis until a post-natal assessment has been done for more accuracy.


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