title: Spina bifida and lower limb amputation in Northern Ireland: A retrospective study of demographics and outcome.
abstract: BACKGROUND
  Spina bifida is an uncommon cause for lower limb amputation. The causes and level of amputation and mobility outcome for these patients have not been reported previously.
  
  
  METHODS
  To identify the causes and level of amputation and the mobility outcome for amputee patients with spina bifida.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Chart review of patients identified by computer as having an amputation secondary to neurological or congenital cause. Additional patients identified from the Regional Spina Bifida Medical Clinic. Demographics, cause and level of mobility pre- and post-amputation recorded from the prosthetic notes.
  
  
  RESULTS
  In total, 16 patients were identified who had a diagnosis of spina bifida and a lower limb amputation. Mean age at the time of amputation was 28.5 years. In total, 15 patients had a transtibial amputation. In total, 14 patients post-amputation were able to maintain their mobility, wheelchair or walking, without any change in type of aid needed.
  
  
  CONCLUSIONS
  Patients with spina bifida appear to require lower limb amputation at a younger age than patients with peripheral vascular disease. Almost all patients had prior chronic skin infection/osteomyelitis as precursors for amputation. The most common level for amputation was transtibial. Mobility was maintained for all patients, albeit for two in a more supported way. Clinical relevance Spina bifida is an uncommon reason for amputation. Patients, are often younger and medically complicated. Chronic skin ulceration, was the most common indication for amputation. Wheelchair or walking ambulance was maintained at the same level for most patients.
authors.affiliation: Regional Disablement Services, Musgrave Park Hospital, Belfast, UK.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Graham
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000671:Amputation, Surgical / Q000379:methods; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D009660:Northern Ireland; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016135:Spinal Dysraphism / Q000175:diagnosis* / Q000534:rehabilitation; D013977:Tibia / Q000601:surgery; D016138:Walking / Q000502:physiology; D014910:Wheelchairs / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Rehabilitation of amputees; amputation; chronic illness; lower limb; rehabilitation; spina bifida