title: Sacral-level myelomeningocele: long-term outcome in adults.
abstract: We reviewed long-term outcome of 46 adult patients with sacral-level myelomeningocele with an average age of 23 years (range, 18-38). Data were collected from the medical records, computerized database, and a questionnaire. Thirty patients had high sacral lesions (weak gluteus medius, gluteus maximums, and gastroc/soleus), and 16 had low sacral lesions (fair to normal-strength gluteus medius, gluteus maximus, and gastroc/soleus). Thirteen patients had signs of tethered-cord syndrome, and 12 underwent neurosurgical release. Thirty-nine patients underwent a total of 217 orthopaedic surgeries. At the final follow-up, 41 (89.13%) patients were community ambulators. Thirty-two required no external support for walking. Twenty-nine patients used some kind of orthosis. Aggressive management of tethered-cord syndrome, surgical correction of musculoskeletal deformities, and avoidance of arthrodesis at the foot level may be the main factors in accounting for these results.
authors.affiliation: Children's Memorial Hospital, Chicago, Illinois, USA.
authors.forename: P
authors.initials: P
authors.lastname: Selber
authors.forename: L
authors.initials: L
authors.lastname: Dias
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D012445:Sacrococcygeal Region; D016136:Spina Bifida Occulta / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome