Neuromuscular function and radioanatomical form of the myelomeningocele hip

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.