Acquired amputations in patients with spina bifida

Area of Science:

• Pediatric Rehabilitation
• Clinical Outcomes
• Spina Bifida Research

Background:

• Spina bifida is a complex congenital condition impacting mobility and increasing risks for secondary complications.
• Pressure injuries are a known complication, particularly in individuals with impaired mobility.
• The risk of lower extremity amputation secondary to pressure injuries in spina bifida patients requires further investigation.

Purpose of the Study:

• To compare the incidence of lower extremity (LE) pressure injuries resulting in amputations between ambulatory and non-ambulatory patients with spina bifida.
• To identify risk factors associated with amputation in spina bifida patients with LE pressure injuries.

Main Methods:

• Retrospective review of medical records from a large pediatric rehabilitation hospital.
• Inclusion criteria: patients with spina bifida and a history of pressure injury between 1997-2018.
• Data analysis focused on mobility status (ambulatory vs. non-ambulatory) and amputation outcomes.

Main Results:

• 112 spina bifida patients developed LE pressure injuries; 53 were ambulatory and 59 were non-ambulatory.
• 11 patients required amputation; 10 were ambulatory and 1 was non-ambulatory.
• Ambulatory patients had a 19% risk of amputation vs. 2% for non-ambulatory patients (p < 0.005), indicating a significantly higher risk.

Conclusions:

• Ambulatory patients with spina bifida and LE pressure injuries are at a substantially elevated risk for amputation.
• Proactive and aggressive monitoring and treatment strategies are essential for ambulatory spina bifida patients with pressure injuries.
• This highlights the need for targeted interventions to prevent severe outcomes like amputation in this population.