Related Experiment Videos
Neuromuscular function and radioanatomical form of the myelomeningocele hip
1Orthopädische Poliklinik des Klinikums Innenstadt, Ludwig-Maximilians-Universität München, Germany.
Insights
Neuromuscular hip changes in children with myelomeningocele vary with spinal paralysis level. Hip abductor and glutei muscle insufficiency correlate with specific angle reductions in the epiphysis and apophysis.
Area of Science:
- Orthopedics
- Pediatric Neurology
- Developmental Biology
Background:
- Myelomeningocele, a severe birth defect, often leads to neuromuscular dysfunction and skeletal deformities.
- Hip joint abnormalities are common in myelomeningocele patients, impacting mobility and long-term orthopedic health.
Purpose of the Study:
- To investigate the relationship between the level of spinal paralysis and the radioanatomical characteristics of the myelomeningocele hip.
- To describe variations in neuromuscular function and hip joint morphology based on spinal cord lesion level.
Main Methods:
- Evaluation of 84 hip joints from 44 children (ages 1-10.75) with myelomeningocele.
- Classification of patients into five groups based on spinal paralysis level.
- Radiographic analysis of anteroposterior pelvic radiographs to measure epiphyseal and apophyseal angles.
Main Results:
- The epiphyseal angle showed distinct average values across paralysis groups, ranging from 0 degrees (thoracic/thoracolumbar) to 14 degrees (distal S1).
- The apophyseal angle followed a characteristic curve, decreasing from group 1 (67 degrees) to groups 2-3 (34-45 degrees) and increasing in groups 4-5 (44-52 degrees).
Conclusions:
- Hip abductor insufficiency is associated with reduced epiphyseal angles in myelomeningocele.
- Relative insufficiency of small glutei muscles contributes to reduced apophyseal angles.
Abstract:
The aim of this study was to describe variants in neuromuscular function and radioanatomical form of the myelomeningocele hip based on the level of spinal paralysis. For this purpose, 84 hip joints of 44 children with myelomeningocele age 1 to 10.75 years were classified into five spinal paralysis groups. Using anteroposterior pelvic radiographs, the position of the capital epiphysis, represented by the epiphyseal angle, and the position of the greater trochanter apophysis, represented by the apophyseal angle, were evaluated. The epiphyseal angle of the five paralysis groups showed three categories of average values. The thoracic/thoracolumbar group had an average of 0 degree, groups 2 (distal L1/L2) and 3 (distal L3/L4) had average values of 5 degrees to 6 degrees, and groups 4 (distal L5) and 5 (distal S1) had average values of 13 degrees to 14 degrees. The average values of the apophyseal angle showed a characteristic curve: the values dropped from group 1 (67 degrees) to groups 2 (45 degrees) and 3 (34 degrees) and then rose in groups 4 (44 degrees) and 5 (52 degrees). The authors concluded that the insufficiency of the hip abductors leads to a reduction of the epiphysis angle, and the relative insufficiency of the small glutei compared with the knee extensors leads to a reduction of the apophysis angle.