Functionality of Lower Limbs in Patients with Orthopedic Manifestations of Spinal Dysraрhism
Spinal dysraрhism is an important cause of static-locomotor disorders in children. Injuries of varying degrees of paralysis or paresis of the lower limbs, dysfunction of the pelvic organs, limbs and spine deformation, which significantly affects the quality of life and ability to movement and maintenance depends on the level of spinal cord lesion. Objective. To assess the ability to move in patients with the consequences of open forms of spinal dysraрhism, depending on the level of functional insufficiency of the lower limbs. Materials and methods. Material of the study were 81 patients aged from 5 to 21 years old (average age was 10 years and 8 months olg), 69 patients experienced paraparesis of the lower extremities, 12 - monoparesis. To determine the level of spinal cord lesion we used Sharrard’s (1964) as modified Bartonek et al. (1999) classification. Ability to move was evaluated by Hoffer et al. (1973) classification. Results and discussion. All patients included in the study are distributed according to the level of functional muscular strength into five clinical groups with a certain level of functional muscular strength by Sharrard’s classification (1964) with Bartonek modification (1999) and estimated actual degree of movement in the patients by Hoffer’s classification. Comparing the actual degree of movement in groups of patients to the theoretically expected degree of movement of patients it was conducted that children with the same level of functional insufficiency of the lower limbs do not always achieve the expected degree of movement, and it depends on the confounding factors such as intellectual (mental) level of a child, the progression of hydrocephalus, obesity, severity of orthopedic pathology, presence of spasticity that impact a degree of movement. Conclusions. The level of the spinal cord lesion that determines the level of muscle function of the lower limbs is an important factor in the ability of patients to move in comorbid spinal dysraphism. Patients with the same level of loss of the muscle function does not always achieve the expected level of movement.