title: The relationship between the level of lesion and progression in Reimer's index of spina bifida patients.
abstract: OBJECTIVE
  We aimed to evaluate the influence of the lesion level and acetabular displasia on the progression of hip dislocation in patients with spina bifida.
  
  
  METHODS
  Two hundred twelve hips of 106 cases with spina bifida were evaluated both clinically and radiologically. Their vertebral level of lesions, clinical examinations, radiological migration index, and acetabulum terms were noted and were evaluated in terms of their relations with the level of lesion-migration and dysplasia. Data analysis method was evaluated using SPSS 22.0 program.
  
  
  RESULTS
  Deficiency of acetabulum was present in 33 % of the cases with spina bifida. Dysplastic floor was found to be as equally important as the level of lesion in the progression of hip dislocation (p = 0.002). Progression and dislocation incidences were observed to be higher in the thoracic level (p = 0.008). Reimer's progression index was seen to be a reliable way of assesment.
  
  
  CONCLUSIONS
  The development of hip dislocation and progression are not solely connected with muscle imbalance. Encountered more frequently in these cases, acetabular dysplasia is a factor that is as important as the level of lesion in the formation of hip dislocation and progression. Hip dislocation is associated with more progression in the higher level lesions. Reimer's index is a reliable assessment criteria.
authors: Department of Orthopedics and Traumatology, Ege University, Izmir, Turkey.
authors: Huseyin
authors: H
authors: Gunay
authors: Department of Orthopedics, Dr Behcet Uz Child Disease and Surgery Research and Training Hospital, Izmir, Turkey. muratcelal@hotmail.com.
authors: Murat Celal
authors: MC
authors: Sozbilen
authors: Department of Orthopedics and Traumatology, Ege University, Izmir, Turkey.
authors: Mahmut
authors: M
authors: Altınisik
authors: Department of Orthopedics and Traumatology, Tepecik Research and Training Hospital, Izmir, Turkey.
authors: Ismail Eralp
authors: IE
authors: Kacmaz
authors: Department of Orthopedics and Traumatology, Ege University, Izmir, Turkey.
authors: Elcil
authors: E
authors: Kaya Bicer
mesh_terms: D000077:Acetabulum / Q000473:pathology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging*; D006617:Hip Dislocation / Q000209:etiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016135:Spinal Dysraphism / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology*; D055815:Young Adult
keywords: Acetabular index; Hip dislocation; Meningomyelocele; Reimer’s migration index; Spina bifida