Longitudinal Retrospective Preliminary Study To Determine The Incidence and Grace of Listhesis in Children with Spina Bifida

Patients and Methods: 183 patients with myelomeningocele were randomly chosen from a roster of >500 patients with myelomeningocele followed at a multidisciplinary spina bifida unit in a tertiary university public hospital. A cross-sectional study was done collecting data from patient records and X-rays archives. X-rays measurements of sacral slope and grade of listhesis were standardized with AutoCad System. To study relationships among the variables, the Chi-squared, ANOVA tests were applied.

Results: The mean age of this series was 23,73 years (range 2-53). 96 were male and 87 were female. 76.4% of patients had mid-lumbar, low-lumbar or sacral neurological levels. 23.5% had spondylolisthesis. The mean slippage was 19.86% (range 6.79-44.41), being 71,9% grade I and the remaining 27.9% grade II. The more frequent level for slippage was L5-S1. All the patients with spondylolisthesis were ambulators, except one adult that currently had lost her ambulation capacity. The presence of spondylolisthesis were statistically related with ambulation (p=0.003). ambulatory type (p=0.007), functional ambulation type (p=0.004), scoliosis (p=0.001), lumbar hyperlordosis (p=0.001), age (p=0.039) and age onset of ambulation (p=0.043). In the multivariable analysis were determinant: the hyperlordosis (p=0.000; IC 95% 0.127-0.415), type of gait (p=0.005; IC 95% -0.121/-0.021) and age (p=0.016;IC 95% -0.014/-0.001).

Conclusions: Prevalence of spondylolisthesis in MMC is greater than in normal population (23.5% vs 5.8%). Ambulation and hyperlordosis were related with the presence of spondylolisthesis.