Related Experiment Video
Updated: Jun 11, 2025
Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis
Published on: March 23, 2019
Influencing Factors on Independent Walking in Children With Lumbosacral Lipomas: A Retrospective Cohort Study Based
Chiaki Takeuchi1, Shiro Sugiura2, Remi Fujita3
1Rehabilitation Section, Clinical Support Division, Aichi Children's Health and Medical Canter, Obu, Aichi, Japan.
Insights
Systemic combined anomalies and malformed conus medullaris significantly delay independent walking in children with lumbosacral lipomas. These factors are crucial for understanding developmental milestones and guiding interventions for affected children.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Spinal Cord Malformations
Background:
- Independent walking is a key developmental milestone for children.
- Limited research exists on the timing of independent walking for children with lumbosacral lipomas.
- Existing evidence is primarily from studies on spina bifida aperta.
Purpose of the Study:
- To investigate factors influencing the achievement of independent walking in children diagnosed with lumbosacral lipomas.
- To identify specific clinical and radiological parameters associated with delayed walking.
Main Methods:
- Retrospective cohort study of 124 children who underwent surgery for lumbosacral lipomas.
- Primary endpoint: age of independent walking (in months).
- Analysis of factors including lipoma type, surgical extent, MRI findings, congenital anomalies, and functional deficits.
Main Results:
- Systemic combined anomalies were the strongest predictor of delayed independent walking (OR=15.5, P<.001).
- Malformed conus medullaris was also significantly associated with delayed walking in a subgroup analysis (P=.014).
- Suburethral cleft and lipoma classification type did not show significant associations with walking delays.
Conclusions:
- Systemic combined anomalies and malformed conus medullaris are critical factors contributing to delayed independent walking in children with lumbosacral lipomas.
- These findings highlight the importance of comprehensive assessment and management for these children.
- Further research may refine understanding and interventions for optimizing walking ability.
Background:
Caregivers are deeply concerned about children achieving independent walking, and evidence-based rehabilitation support is beneficial. However, current research is confined to a single study on spina bifida aperta, leaving a gap in understanding the timing of independent walking for lumbosacral lipomas.
Objectives:
This study aimed to examine the factors influencing independent walking in children with lumbosacral lipomas.
Design:
Retrospective cohort study.
Methods:
This retrospective cohort study included 124 children who underwent untethering surgery for lumbosacral lipomas. The age (in months) at which the children walked independently was used as the primary endpoint, and potential influencing factors, including the type of spinal lipoma, extent of lipoma removal, magnetic resonance imaging features, congenital anomaly complications, urinary/defecation management requirements, foot/toe symptoms, and orthotic device fabrications were analyzed.
Results:
Multiple logistic regression analysis showed that the most significant influencing factor for delayed independent walking was the presence of systemic combined anomalies (adjusted odds ratio = 15.5, P < .001), while non-systemic malformations, such as suburethral cleft, had limited effects. A subgroup analysis of 94 patients without systemic combined anomalies showed that the presence of a malformed conus medullaris was significantly associated with delayed independent walking (P = .014). The median age of independent walking in children with Morota's classification type 2 was 14 months, which is 1 month later compared to other types, although this difference was not significant (P = .055).
Conclusion:
Our findings suggest that complications arising from systemic combined anomalies and the presence of malformed conus medullaris are influencing factors in delays in independent walking in children with untethered lumbosacral lipomas.
More Related Videos
06:28Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
05:30Surgical Approach and Complications of Stand-alone Lateral Trans-Psoas Interbody Fusion
Published on: February 14, 2025