Clinical implications of the neurosegmental level of injury in the treatment of hip dislocation and subluxation in children with spina bifida
- Authors: Baindurashvili A.G.1, Ivanov S.V.1, Kenis V.M.1
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Affiliations:
- The Turner Scientific and Research Institute for Children’s Orthopedics
- Issue: Vol 4, No 4 (2016)
- Pages: 6-11
- Section: Articles
- URL: https://bakhtiniada.ru/turner/article/view/5889
- DOI: https://doi.org/10.17816/PTORS446-11
- ID: 5889
Cite item
Abstract
Background. Hip dislocation and subluxation are common in children with spina bifida.
Aim. To determine the influence of the neurosegmental level on surgical treatment of hip dislocation and subluxation in children with spina bifida.
Materials and methods. A total of 114 pediatric patients with spina bifida and hip dislocation and subluxation were treated at The Turner Scientific and Research Institute for Children’s Orthopedics (Saint Petersburg, Russia) from 2006 to 2015. The patients were divided into two groups according the Sharrard classification of neurosegmental lesions: a study group of 62 patients who underwent hip stabilization surgery and a control group of 52 patients who did not undergo hip stabilization procedures.
Results. For patients with a high neurosegmental level (thoracic and L1-L2), surgical treatment for hip dislocation and subluxation, which included most cases (72%), led to motor deterioration (retrospective study). Of 40 patients with a neurosegmental level of L3-L4 and L5-S1, motor level improved in 13 (32.5%) but deteriorated in 10 (36%) of 28 patients in the control group.
Conclusion. Determination of the neurosegmental level enables the prediction of motor level and reveals indication for surgical treatment.Full Text
##article.viewOnOriginalSite##About the authors
Alexei G. Baindurashvili
The Turner Scientific and Research Institute for Children’s Orthopedics
Author for correspondence.
Email: turner01@mail.ru
MD, PhD, professor, member of RAS, honored doctor of the Russian Federation, Director of The Turner Scientific and Research Institute for Children’s Orthopedics Russian Federation
Stanislav V. Ivanov
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: turner01@mail.ru
MD, PhD, research associate of the department of foot pathology, neuroorthopedics and systemic diseases Russian Federation
Vladimir M. Kenis
The Turner Scientific and Research Institute for Children’s Orthopedics
Email: kenis@mail.ru
MD, PhD, professor, Deputy Director of Development and International Relations, head of the department of foot pathology, neuroorthopedics and systemic diseases Russian Federation
References
- Asher M, Olson J. Factors affecting the ambulatory status of patients with spina bifida cysticа. J Bone Joint Surg Am. 1983;65(3):350-6.
- Correll J, Gabler C. The effect of soft tissue release of the hips on walking in myelomeningocele. J Pediatr Orthop B. 2000;9(3):148-153. doi: 10.1097/01202412-200006000-00003.
- Feiwell E, Sakai D, Blatt A. The effect of hip reduction on function in patients with myelomeningocele. Potential gains and hazards of surgical treatment. J Bone Joint Surg Am. 1978;60(2):169-73.
- Erol B, Bezer M, Kucukdarmaz F, et al. Surgical management of hip instabilities in children with spina bifida. Acta Orthop Traumatol Turc. 2005;39(1):16-22.
- Баиндурашвили А.Г., Иванов С.В., Кенис В.М. Подвывих и вывих бедра у детей с последствиями спинномозговых грыж (обзор литературы) // Травматология и ортопедия России. – 2013. – № 4. – С. 97–102. [Baindurashvili AG, Ivanov SV, Kenis VM. Subluxation and dislocation of the hip in children with spina bifida (Review). Traumatology and Orthopedics of Russia. 2013;(4):97-192. (In Russ.)]
- Бадалян Л.О. Невропатология. – М.: Просвещение, 1987. – 316 с. [Badalyan LO. Nevropatologiya. Moscow: Prosvechenie; 1987. 316 p. (In Russ.)]
- Иванов С.В., Кенис В.М., Икоева Г.А., и др. Использование роботизированной двигательной реабилитации в комплексном лечении подвывиха и вывиха бедра у детей с последствиями спинномозговой грыжи // Ортопедия, травматология и восстановительная хирургия детского возраста. – 2014. – Т. II. – Вып. 4. – С. 32–35. [Ivanov SV, Kenis VM, Ikoeva GA, et al. The use of robotic rehabilitation in complex treatment of subluxation and dislocation of the hip in children with sequelae of spina bifida. Pediatric Traumatology, Orthopaedics and Reconstructive Surgery. 2014;2(4):32-5. (In Russ.)]
- Thomson JD, Segal LS. Orthopedic managment of spina bifida. Dev Disabill Res Rev. 2010;16(1):96-103. doi: 10.1002/ddrr.97.
- Yildirim T, Gursu S, Bayhan İA, et al. Surgical treatment of hip instability in patients with lower lumbar level myelomeningocele: Is muscle transfer required? Clin Orthop Relat Res. 2015;473(10):3254-60. doi: 10.1007/s11999-015-4316-8.
- Sharrard WJW. The segmental innervation of the lower limb muscles in man. Ann R Coll Surg Engl. 1964;35:106-22.
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