Neurological abnormalities, major orthopaedic deformities and ambulation analysis in a myelomeningocele population in Catalonia (Spain).
The aim of the study was to analyze the present status of neurologic abnormalities, major orthopaedic deformities and ambulatory status in a large myelomeningocele population.


METHODS
Cross-sectional study based on the clinical and radiographic records of 322 patients treated and followed-up from 1967-1995. The setting was a multidisciplinary spina bifida unit within a third-level university hospital, which serves as the referral centre for these patients in Catalonia (Spain). We collected information on diagnosis, central nervous system, musculoskeletal system (spinal and hip deformities) and functional level in each patient. To study relationships among the variables, the Mann-Whitney U and the Chi-squared tests were applied. Results were considered to be statistically significant at P levels of < or = 0.05.


RESULTS
Mean age was 15.9 years. 78.1% of patients had mid-lumbar, low-lumbar or sacral neurological levels; 97.5% had hydrocephalus and 68.8% were shunted. Prevalence of spine deformities was 45.3%; 38.8% had dislocation of one or both hips. Median age of walking onset was 37.1 months and 74.8% of patients were ambulatory. Median age at which ambulation ceased was 128 months (10 years and 8 months). The bivariate analysis showed statistically significant relationships between neurological level and all the variables studied (P<0.001, P<0.02) except body mass indexes and intelligence quotient.


CONCLUSIONS
Neurological level was the main factor that determined neurological abnormalities, major orthopaedic deformities and ambulatory status.
Iborra
J
J
Spina Bifida Unit, Hospital de Traumatología y Rehabilitación, Vall d'Hebron Hospitals, Barcelona, Spain.
Pagès
E
E
Cuxart
A
A
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007223:Infant; D008124:Locomotion; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D009139:Musculoskeletal Abnormalities / Q000453:epidemiology / Q000209:etiology*; D009421:Nervous System Malformations / Q000453:epidemiology / Q000209:etiology*; D009460:Neurologic Examination; D013030:Spain / Q000453:epidemiology; D018709:Statistics, Nonparametric