Table 2.
Clinical data on the 32 patients with lipomyelomeningocele enrolled in the study
| Case | Gender | Neurology level | Age at follow-up (years | TCRa | Age at TCR | Repeat TCRa | MSK issues | Spine deformitya | PSH | Functional statusb | Orthotics | Assistive device |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Female | Left L3 | 14 | Y | 2 months | N | Equinovalgus foot ETT, LLD (2.5 cm) hallux valgus | N | L TAL × 2, vulpius calcaneal lengthening | C | DAFO #4 lift for LLD | None |
| 2 | Male | Symmetric L5/S1 weakness | 11 | Y | 6 months | Y ×11 | B/L Eq-valgus foot deformities | N | B/L calcaneal length vulpius, PL/PB length | C | DAFO #4 | None |
| 3 | Male | Left L4/5 | 13 | Y | <1 year | N | LLD (5 cm), Left ETT left calcaneovalgus | N | Left PMR, TAL, SPLATT tibia rotational osteotomy: right tibia epiphysiodesis | C | B/L AFO’s | None |
| 4 | Female | Symmetric LE weakness | 29 | Y | 24 years | Y | Scoliosis | Y | Multiple foot procedures | C | NR | Cane |
| 5 | Male | Right LE weakness | 61 | Y | 46 years | Y | None noted | N | No orthopaedic procedures | W | None | WC |
| 6 | Female | Motor intact decreased distal sensation | 16 | Y | 6 months | Y ×2 | B/L cavovarus foot LLD (1 cm), trophic ulcers | Y | PT transfer, B/L PFR and 1st MTO | C | B/L UCBL | None |
| 7 | Male | Left LE weakness | 29 | Y | 6 months | Y ×4 | LLD (5 cm) | N | Left TAL | C | Left AFO | None |
| 8 | Female | Normal motor left decreased sensation | 36 | Y | 30 years | Y ×2 | None noted | N | No orthopaedic procedures | N | None | None |
| 9 | Female | Right L4/L5 weakness | 9 | Y | 2 months | N | Cavus deformity | N | LLD (2.5 cm) | N | None | None |
| 10 | Female | Normal | 8 | Y | 7 years | Y ×1 | Scoliosis (10°) | Y | No orthopaedic procedures | N | None | None |
| 11 | Female | Left L5–S1 | 31 | Y | 12 years | Y ×2 | Left cavus, clubfoot, scoliosis (45°), LLD (4 cm) | Y | Left triple arthrodesis, midfoot osteotomy long LD | C | Left AFO, | Walker for long LD |
| 12 | Male | Symmetricdistal weakness and sensation | 53 | Y | 25 years | Y ×2 | Cavus and trophic ulcers | N | No orthopaedic procedures | C | B/L AFO’s | None |
| 13 | Female | Normal | 14 | Y | 2 months | N | LLD (2.5 cm), grade II spondylolisthesis | Y | Right TAL, calcaneal lengthening | N | Right shoe lift | None |
| 14 | Female | Right LE weakness | 20 | Y | 16 years | N | Scoliosis (62°) | Y | No orthopaedic procedures | C | Right FRAFO, | Lofstrand WC for LD |
| 15 | Male | Symmetric L4 | 16 | Y | 4 months | Y ×2 | Scoliosis (19°) | Y | No orthopaedic procedures | N | None | None |
| 16 | Male | Left L3/L4 | 25 | Y | 20 months | Y ×3 | LLD (2.5 cm), cavus trophic ulcers | N | Left calc lengthening, PFR, multiple tendon releases left foot | C | Left AFO | Cane |
| 17 | Male | Left LE distal weakness | 18 | Y | <6 months | N | LLD (>2 cm), left cavus, scoliosis (14°) | Y | Right tibia epiphysiodesis left calcaneal osteotomy, PFR | C | Left AFO | None |
| 18 | Female | Left LE weakness | 16 | Y | 1 months | Y ×2 | LLD (2.5 cm), ETT left hip dyplasia, left FA right calcaneus | N | Right tibia epiphysiodesis B/L VDRO and muscle transfers | C | B/L AFO’s | Lofstrand WC for LD |
| 19 | Male | Right LE weakness | 9 | Y | <6 months | N | LLD (1 cm), right cavus, claw toes | N | No orthopaedic procedures | N | None | None |
| 20 | Female | Normal | 13 | Y | 3 months | N | Left equinus | N | No orthopaedic procedures | N | None | None |
| 21 | Female | Right LE weakness | 16 | Y | 4 months | Y ×1 | Right cavovarus foot, trophic ulcer | N | Right PFR, Jones procedure cuneiform osteotomy | N | None | None |
| 22 | Female | Left LE weakness | 32 | Y | NR | N | LLD (4 cm), right hip dysplasia | N | Right VDRO, HWR | N | None | None |
| 23 | Female | Right LE decreased sensation | 14 | Y | 9 months | N | None noted | N | No orthopaedic procedures | N | None | None |
| 24 | Female | Right LE | 33 | Y | NR | Y | Low back pain | N | Placement spinal cord stimulator for back pain | C | B/L AFO’s | None |
| 25 | Male | Normal | 15 | Y | 2 years | N | None noted | N | No orthopaedic procedures | N | None | None |
| 26 | Female | Normal | 30 | Y | NR | Y ×3 | Chronic low back pain | N | No orthopaedic procedures | N | None | None |
| 27 | Female | Normal | 46 | Y | 39 years | Y ×1 | Claw toes | N | No orthopaedic procedures | N | None | None |
| 28 | Female | Left LE weakness | 23 | Y | NR | Y ×1 | LLD (3 cm), Left FA ETT, cong scoliosis | Y | Femoral and tibial rotational osteotomies ASF + PSF | C | B/L AFO’s | None |
| 29 | Female | L5/S1 weakness | 15 | Y | 5 years | Y ×2 | Left hallux valgus | N | No orthopaedic procedures | N | None | None |
| 30 | Female | Normal | 9 | Y | <6 months | N | Scoliosis (17°) | Y | No orthopaedic procedures | N | None | None |
| 31 | Male | Normal | 8 | Y | 2 months | N | None noted | N | No orthopaedic procedures | N | None | None |
| 32 | Female | Left L3 weakness | 19 | Y | 7 months | Y ×1 | LLD (2.5 cm) | N | Right femoral epiphysiodesis | C | Right KAFO | None |
AFO ankle foot orthosis, ASF anterior spine fusion, B/L bilateral, DAFO Dynamic Ankle Foot Orthosis (Cascade, Ferndale, WA), ETT external tibial torsion, FA femoral anteversion, FRAFO floor reaction ankle foot orthosis, HWR hardware removal, KAFO knee ankle foot orthosis,L lumbar, LD long distances, LE lower extremity, LLD limb length discrepancy,MSK musculoskeletal, MTO metatarsal osteotomy, NR not recorded, PFR plantar fascia release, PL/PB peroneus longus/brevis tendons, PMR posteromedial release, PSF posterior spine fusion, PT posterior tibial tendon,S sacral, SPLATT split anterior tibial tendon transfer, TAL tendoachilles lengthening,TCR tethered cord release, UCBL University California Berkeley Lab orthosis, VDRO varus derotational osteotomy, WC wheelchair
aY, Yes; N, no
bSee Table 1