Skip to main content
SpringerLink
Log in

Neuro-orthopaedic conditions in spina bifida: natural course and their management and long-term outcomes

  • Special Annual Issue
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Introduction

Management of spina bifida is a complex issue with various systems of the body involved either directly or indirectly.

Discussion

Deformities of the bone and joints (especially spine and lower limbs) play a significant role in causation of deficits in the child. Management of these deficits require a focused, specialised and multidisciplinary approach with orthopaedician, physiotherapist, intensivist and psychologist apart from neurosurgeon playing an important part. To manage these deformities, one needs to understand the pathophysiology of causation of these defects. The corrective surgical intervention ranges from a simple release of contracture to highly complex spinal instrumentations.

Conclusion

We reviewed the literature and have shared our experience on this aspect of spina bifida.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Mclone DG, DiasLS, Kaplan WE (1984) Concepts in management of spina bifida. In: Concepts of paediatric neurosurgery, Vol 5: S Karger, Basel

  2. Menelaus MB (1980) The orthopaedic management of spina bifida cystica. Churchill Livingstone, Edinburgh

    Google Scholar 

  3. Swaroop VT, Dias L (2009) Orthopedic management of spina bifida. Part I: hip, knee, and rotational deformities. J Child Orthop 3:441–449

    Article  PubMed  Google Scholar 

  4. Guille JT, Sarwark JF, Sherk HH, Kumar SJ (2006) Congenital and developmental deformities of the spine in children with myelomeningocele. J Am Acad Orthop Surg 14:294–302

    PubMed  Google Scholar 

  5. Dias LS The orthopaedic aspects of spinal dysraphism. In: The Paediatric spine I: Development and the dysraphic state

  6. Mayfield JK Comprehensive orthopaedic management in myelomeningocele. In: Comprehensive management of spina bifida

  7. Neuromuscular disorders (2008) In: Herring J (ed) Tachdjian’s pediatric orthopaedics. Saunders Elsevier, Philadelphia, pp 1405–1453

    Google Scholar 

  8. McDonald CM, Jaffe KM, Mosca VS, Shurtleff DB (1991) Ambulatory outcome of children with myelomeningocele: effect of lower-extremity muscle strength. Dev Med Child Neurol 33:482–490

    Article  PubMed  CAS  Google Scholar 

  9. Pillard D, Massy P, Taussing G (1981) The hip in myelomeningocele. Orthop Trans 5:61

    Google Scholar 

  10. Banta JV, Whiteman S, Dyck RM, Hartleip D, Gilbert D (1976) Fifteen years review of myelodysplasia. J Bone Joint Surg 58A:726

    Google Scholar 

  11. Hall JE, Martin R (1970) The natural history of spine deformity in myelomeningocele. A study of 130 patients. Proc Can Orthop Assoc. Bermuda, June 1970

  12. Mackel JL, Lindseth RE (1975) Scoliosis in myelodysplasia. J Bone Joint Surg 57A:1031

    Google Scholar 

  13. Moe JK, Winter RB, Bradford DS, Lonstein JE (1987) Scoliosis and other spinal deformities. Saunders, Philadelphia

    Google Scholar 

  14. Piggott H (1980) The natural history of scoliosis in myelodysplasia. J Bone Joint Surg 62B(1):54–58

    Google Scholar 

  15. Shurleff DB, Bourney R, Gordon LH, Livermore N (1976) Myelodyspalsia: the natural history of kyphosis and scoliosis. A preliminary report. Dev Med Child Neurol 18(Suppl 37):126–133

    Google Scholar 

  16. Lindseth R (2001) Myelomeningocele spine. In: Weinstein S (ed) The pediatric spine: principles and techniques, 2nd edn. Lippincott Williams and Wilkins, Philadelphia, pp 845–868

    Google Scholar 

  17. Sriram K, Bobetchko K, Hall J (1972) Surgical management of spinal deformities in spina bifida. J Bone Joint Surg Br 54:666–676

    PubMed  CAS  Google Scholar 

  18. Osebold WR, Mayfield JK, Winter RB, Moe JH (1982) Surgical treatment of the paralytic scoliosis associated with myelomeningocele. J Bone Joint Surg 64A:841–856

    Google Scholar 

  19. Mazur J, Menelaus MB, Dickens DR et al (1986) Efficacy of surgical management for scoliosis in myelomeningocele: correction of deformity and alteration of functional status. J Pediatr Orthop 6:568–575

    Article  PubMed  CAS  Google Scholar 

  20. Banit DM, Iwinski HJ Jr, Tawalkar V et al (2001) Posterior spinal fusion in paralytic scoliosis and myelomeningocele. J Pediatr Orthop 21:117–125

    Article  PubMed  CAS  Google Scholar 

  21. Basobas L, Mardjetko S, Hammerberg K et al (2003) Selective anterior fusion and instrumentation for the treatment of neurovascular scoliosis. Spine 28:S245–S248

    Article  PubMed  Google Scholar 

  22. Dunn H (1983) Kyphosis of myelodysplasia: operative treatment based on pathophysiology. Orthop Trans 7:19

    Google Scholar 

  23. Nolden MT, Sarwark JF, Vora A et al (2002) A kyphectomy technique with reduced peri-operative morbidity for myelomeningocele kyphosis. Spine 27:1807–1813

    Article  PubMed  Google Scholar 

  24. Heydemann JS, Gillespie R (1987) Management of myelomeningocele kyphosis in the older child by kyphectomy and segmental spinal instrumentation. Spine 12:37–41

    Article  PubMed  CAS  Google Scholar 

  25. Hall JE, Poitras B (1977) The management of kyphosis in patients with myelomeningocele. Clin Orthop Relat Res 128:33–40

    PubMed  Google Scholar 

  26. Feiwell E, Sakar D, Blatt T (1978) The effect of hip reduction on function in patients with myelomeningocele: potential gains and hazards of surgical care. J Bone Joint Surg 60A:169

    Google Scholar 

  27. Lindseth RE(1990) Myelomeningocele. In: Paediatric Orthopaedics. Vol 1, ed 3

  28. Lindseth RE (1976) Treatment of the lower extremity in children paralysed by myelomeningocele. Instr Course Lect 25:76–82

    Google Scholar 

  29. Parsch K, Manner G (1976) Prevention and treatment of knee problems in children with spina bifida. Div Med Child Neurol 18(6):114

    Google Scholar 

  30. Selber P, Dias L (1998) Sacral-level myelomeningocele: longterm outcome in adults. J Pediatr Orthop 18:423–427

    PubMed  CAS  Google Scholar 

  31. Noonan KJ, Didelot WP, Lindseth RE (2000) Care of the pediatric foot in myelodysplasia. Foot Ankle Clin 5(2):281–304

    PubMed  CAS  Google Scholar 

  32. Swaroop VT, Dias L (2011) Orthopaedic management of spina bifida—part II: foot and ankle deformities. J Child Orthop 5:403–414

    Article  PubMed  Google Scholar 

  33. Gerlach DJ, Gurnett CA, Limpaphayom N, Alaee F, Zhang Z, Porter K, Kirchhofer M, Smyth MD, Dobbs MB (2009) Early results of the Ponseti method for the treatment of clubfoot associated with myelomeningocele. J Bone Joint Surg Am 91(6):1350–1359

    Article  PubMed  Google Scholar 

  34. Flynn JM, Herrera-Soto JA, Ramirez NF, Fernandez-Feliberti R, Vilella F, Guzman J (2004) Clubfoot release in myelodysplasia. J Pediatr Orthop B 13:259–262

    Article  PubMed  Google Scholar 

  35. Kodros SA, Dias LS (1999) Single-stage surgical correction congenital vertical talus. J Pediatr Orthop 19(1):42–48

    PubMed  CAS  Google Scholar 

  36. Park KB, Park HW, Joo SY, Kim HW (2008) Surgical treatment of calcaneal deformity in a select group of patients with myelomeningocele. J Bone Joint Surg Am 90(10):2149–2159

    Article  PubMed  Google Scholar 

  37. Westcott MA, Dynes MC, Remer EM, Donaldson JS, Dias LS (1992) Congenital and acquired orthopedic abnormalities in patients with myelomeningocele. Radiographics 12:1155–1173

    PubMed  CAS  Google Scholar 

  38. Dias L (2004) Orthopaedic care in spina bifida: past, present, and future. Dev Med Child Neurol 46:579

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), Rishikesh, India

    Raj Kumar

  2. Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India

    Anant Mehrotra

  3. Department of Orthopaedics, All India Institute of Medical Sciences (AIIMS), Rishikesh, India

    Sumit Banerjee

Authors
  1. Raj Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anant Mehrotra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sumit Banerjee
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Raj Kumar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kumar, R., Mehrotra, A. & Banerjee, S. Neuro-orthopaedic conditions in spina bifida: natural course and their management and long-term outcomes. Childs Nerv Syst 29, 1581–1587 (2013). https://doi.org/10.1007/s00381-013-2146-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-013-2146-0

Keywords

Search

Navigation