MOTOR FUNCTION IN FIVE-YEAR-OLD SPINA BIFIDA PATIENTS AS A PREDICTIVE FACTOR OF FUTURE SPINAL DEFORMATIONS

Abstract

Purpose of the study: In spina bifida, independently of limb paralysis, spinal deformation can cause significant static disorders (scoliosis, kyphosis, or hyperlordosis) which in turn cause significant disability. These deformations generally develop during growth. We wanted to determine the predictive value of a clinical classification based on the neurological examination at five years for risk of spinal deformation.

Material: This retrospective study included 163 patients. Groups were defined on the basis of motor function determined by the neurological examination at five years: group I: L5 or below (all patients in this group had motor deficit leaving at least one L5 segment intact); group II: L3–L4; group III: L1–L2; group IV: T12 and above.

Results: Results showed that group I was a factor predictive of an absence of future spinal deformation. Groups III and IV were predictive of presence of a future spinal deformation. Group IV was predictive of future kyphosis.

Discussion: It is well known that the higher the neurological lesion in spina bifida, the higher the rate of spinal deformation. No work has however set the limits nor provided predictive rules useful in clinical practice. Our work demonstrated that this classification based on the motor function established by neurological examination at five years can predict which children have a risk of developing a spinal deformation and thus enabling early detection and treatment.

Conclusion: This neurological classification can be used as a clinical tool for the prognostic evaluation of spina bifida.