Walking ability in mature patients with spina bifida

Area of Science:

• Orthopedics
• Neurology
• Rehabilitation Medicine

Background:

• Spina bifida affects ambulatory status.
• Factors influencing ambulation require further investigation.

Purpose of the Study:

• To assess the ambulatory status of spina bifida patients.
• To correlate ambulation with lesion level, hip joint status, pelvic obliquity, and scoliosis.

Main Methods:

• Retrospective study of 50 patients (aged 15+) with spina bifida.
• Analysis of lesion level, hip joint stability/deformity, pelvic obliquity, and scoliosis.
• Evaluation during the year of walking initiation and cessation.

Main Results:

• Over two-thirds of patients were community ambulators.
• No household or nonfunctional ambulators were identified.
• Ambulators had lesion levels from T11 to S2-S3; nonambulators from T12 to L3-L4/L4.
• Early hip surgery prevented dislocation in most cases.
• Hip flexion deformity, pelvic obliquity, and scoliosis, individually or combined, negatively impact walking.

Conclusions:

• Ambulatory status in spina bifida is multifactorial.
• Early intervention for hip stability is beneficial.
• Severe hip deformity, pelvic obliquity, or scoliosis can preclude ambulation.