Skeletal maturity in myelomeningocele
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Published on: April 23, 2021
Brian T Feeley1, Tze C Ip, Norman Y Otsuka
1Shriners Hospitals for Children, Los Angeles, California, USA.
Insights
This study found that myelomeningocele patients with a ventriculoperitoneal shunt had delayed bone age. Gender and myelomeningocele level did not impact skeletal maturity, highlighting shunt presence as a key factor.
Area of Science:
- Pediatric Orthopedics
- Developmental Biology
- Neurosurgery
Background:
- Myelomeningocele is a complex congenital condition affecting skeletal development.
- Skeletal maturity is crucial for planning orthopedic interventions in these patients.
- Hydrocephalus and its treatment, such as ventriculoperitoneal shunts, may influence growth.
Purpose of the Study:
- To investigate the association between gender, hydrocephalus (indicated by ventriculoperitoneal shunt presence), and myelomeningocele level with skeletal maturity.
- To determine if these factors impact bone age in pediatric patients with myelomeningocele.
Main Methods:
- Retrospective analysis of 90 patients diagnosed with myelomeningocele.
- Assessment of skeletal maturity using the Oxford method to determine bone age.
- Comparison of bone age based on gender, myelomeningocele level, and presence of a ventriculoperitoneal shunt.
Main Results:
- A statistically significant lower mean bone age was observed in patients with a ventriculoperitoneal shunt.
- No significant differences in bone age were found when comparing by gender.
- Myelomeningocele level did not demonstrate a significant association with bone age.
Conclusions:
- Ventriculoperitoneal shunt placement is associated with delayed skeletal maturity in patients with myelomeningocele.
- Understanding these factors is vital for optimizing surgical planning, including osteotomies, epiphysiodesis, and scoliosis correction.
- Further research may explore the mechanisms behind shunt-related effects on bone development.
Abstract:
A retrospective analysis of 90 patients (37 boys, 53 girls) with myelomeningocele was performed to determine the relationship between gender, presence of hydrocephalus, and level of myelomeningocele with skeletal maturity, as measured by bone age. Bone age was assessed using the Oxford method of skeletal maturity. A ventriculoperitoneal shunt was present in 56 of the 90 patients. The mean bone age was found to be significantly less in patients with a ventriculoperitoneal shunt. There was no difference in bone age when comparing gender or level of myelomeningocele. Identification of factors affecting skeletal maturity in patients with myelomeningocele is important in surgical planning for therapeutic operations such as osteotomies, timing of epiphysiodesis, and spinal fusion for scoliosis.
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