Journal of Bone and Joint Surgery, 1973;55:137-148.
© 1973 by The Journal of Bone and Joint Surgery, Inc
Functional Ambulation in Patients with Myelomeningocele
M. MARK HOFFER M.D.1,
EARL FEIWELL M.D.1,
RALPH PERRY M.D.1,
JACQUELIN PERRY M.D.1, and
CHARLES BONNETT M.D.1
1 From the Children's Reconstructive and cerebral Palsy Service, the Kinesiology Service, and the Spine Deformities Service of Rancho Los Amigos Hospital, Downey, and Departments of Orthopedic Surgery and Pediatrics of the University of Southern California School of Medicine, Los Angeles
The factors important in achieving good walking status in myelomeningocele include level of paraplegia, the additional anomalies of brain and kidney, the intelligence, and the home environment. In a group of fifty-six patients none of those with lesions of the thoracic level walked and all of those with lesions of the sacral level walked. In those with lesions at lumbar levels (twenty-one lower and nineteen upper) fourteen were community ambulators and five household ambulators. The other twenty-one were either wheel-chair (nineteen) or non-functional ambulators (two) and the level of paraplegia did not seem to matter nor did the extent of surgery. Some very young non-functional ambulators rose in functional level, but in most instances the trend was to deteriorate.
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