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Prevalence and risk factors for scoliosis in adults with closed and open spina bifida: A large, cross-sectional study - 04/04/23

Doi : 10.1016/j.rehab.2022.101685 
Marine Cacioppo a, b, c, d, , Hélène Menard e, Camille Olivari Philiponnet a, e, Estelle Le Pabic f, Charlène Brochard e, g, Benoit Peyronnet e, h, Philippe Violas e, i, Laurent Riffaud e, j, k, Isabelle Bonan a, e, l
a Department of Physical Medicine and Rehabilitation, Rennes University Hospital, Rennes 35033, France 
b Department of Physical Medicine and Rehabilitation, Brest University Hospital, 2 avenue Foch, Brest 29200, France 
c Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, France 
d Department of Paediatric Physical Medicine and Rehabilitation, Ildys Foundation, Brest 29200, France 
e Centre de référence maladies rares Spina Bifida, site constitutif du centre de référence C-MAVEM, CHU Rennes, Rennes 35000, France 
f CIC Inserm 1414. Clinical Data Centre, Rennes University Hospital, Rennes 35033, France 
g Department of Gastro-enterology, Rennes University Hospital, Rennes 35033, France 
h Department of Urology, Rennes University Hospital, Rennes 35033, France 
i Department of Orthopaedic Children surgery, Rennes University Hospital, Rennes 35033, France 
j Department of Neurosurgery, Rennes University Hospital, Rennes 35033, France 
k INSERM MediCIS, Unit U1099 LTSI, Rennes 1 University, Rennes, France 
l Unité Empenn (ex-Visages) U1228 INSERM-INRIA, IRISA UMR CNRS 6074, Campus de Beaulieu, Rennes Cedex 35042, France 

Corresponding author.

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Highlights

Scoliosis was present in 57% of individuals with open and 45% with closed dysraphism.
70% of adults with dysraphism had backpain whether they had scoliosis or not.
Asymmetrical motor deficit and low walking ability were risk factors for scoliosis.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

Scoliosis develops in a proportion of children with myelomeningocele; however, little is known about scoliosis in adulthood and in other forms of spina bifida (SB).

Objectives

The aims of this study were to describe the prevalence of scoliosis and identify risk factors for its development in a large cohort of adults with open and closed SB.

Methods

This was a cross-sectional study of data from 580 adults with SB attending their first consultation at a French multidisciplinary referral centre for SB. Sex, anatomical location and type of SB (open or closed), neurological level, back pain and ambulatory status (new Functional Ambulation Classification [new FAC]) were compared in adults with and without scoliosis. These characteristics were used to determine scoliosis risk factors.

Results

In total, 331 adults fulfilled the inclusion criteria: 221 had open and 110 had closed SB. Of these, 176 (53%) had scoliosis: 57% open and 45% closed SB. As compared with individuals without scoliosis, those with scoliosis more frequently had open SB (p=0.03), more cranially located SB (p<0.0001), more severe neurological deficits (p≤0.02) and poorer walking ability (mean new FAC score 3.5 [SD 3.3] vs 6.1 [2.6], [p<0.0001]). In total, 69% had chronic back pain, with no difference in frequency between those with and without scoliosis. The odds of scoliosis was associated with asymmetrical motor level and a new FAC score <4 (odds ratio 0.46, p<0.006, and 0.75, p<0.0001, respectively).

Conclusion

About half of adults with open and closed SB had scoliosis. Back pain was frequent in those both with and without scoliosis. Individuals with low walking ability and an asymmetrical motor level should be monitored early and continuously to limit the consequences of scoliosis during their lifetime. A major issue is to determine how scoliosis evolves and to determine appropriate monitoring and treatment strategies for individuals at risk.

Le texte complet de cet article est disponible en PDF.

Keywords : Spina bifida, Spinal dysraphism, Neural tube defect, Scoliosis, Spinal deformity, Myelomeningocele


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Vol 66 - N° 2

Article 101685- mars 2023 Retour au numéro
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