Spinal Dysraphism: A Cross-sectional and Retrospective Multidisciplinary Clinic-based Study

Background

Spinal dysraphism is a common birth defect that causes different kinds of secondary impairments, including joint deformities, reduced mobility, and bowel/bladder dysfunction. Due to the diversity in terminology, cultural/ethnic differences, and medical policies, prior study results cannot be generalized to all populations. Therefore, we performed this study to define the characteristics of patients in Taiwan with spinal dysraphism.

Methods

Patients diagnosed with a myelomeningocele or lipomyelomeningocele were identified from the database of our spinal dysraphism multidisciplinary clinic. A cross-sectional study was conducted by telephone interview and retrospective chart review. Clinical characteristics, such as neurologic level, orthopedic deformities, assistive device use, and level of ambulation, were collected. Spearman's correlation (r) tests were performed between ambulation or neurologic level and other variables.

Results

Seventy-eight subjects were included in the current study. Subjects with myelomeningoceles had more severe neurologic involvement, poorer ambulation outcome, and higher rates of orthopedic deformities, assistive device use, lower hand function, and bowel/bladder dysfunction. The correlation test revealed that the level of ambulation was negatively influenced by a higher neurologic level, a history of shunt placement, and various orthopedic deformities. Neurologic level also had widespread influence on history of shunt placement, orthopedic deformities, assistive device use, the need for additional assistive devices, aggressiveness of assistive devices, and bowel/bladder dysfunction.

Conclusions

For patients with spinal dysraphism, the neurologic level is the most important prognostic factor for many other clinical characteristics, including ambulation status.

Key Words:  ambulation , assistive devices , neurologic deficits , spinal dysraphism

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