Dysraphismes


Le 01/12/2022 de 17:00 à 18:30


Retour Session

CO041

Prévalence et facteurs de risque de scoliose chez les adultes atteints de dysraphisme spinal ouvert et fermé

Marine Cacioppo (BREST, France), Helene Menard (Rennes, France), Camille Olivari-Philiponnet (Rennes, France), Estelle Le Pabic (Rennes, France), Charlène Brochard (Rennes, France), Benoit Peyronnet (Rennes, France), Philippe Violas (Rennes, France), Laurent Riffaud (Rennes, France), Isabelle Bonan (Rennes, France)

Objective : Scoliosis is one of the most severe orthopaedic conditions in patients with spina bifida (SB). 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.
 

Material / Patients and Methods : This cross-sectional study was conducted in a multidisciplinary referral centre for SB in France. Data for consecutive individuals coming from all over France and attending an expert consultation were collected: sex, anatomical location and type of SB (open or closed), neurological level, back pain and ambulatory status (Functional Ambulation Classification (FAC)). These characteristics were compared in adults with and without scoliosis, and used to determine scoliosis risk factors.
 

Results : 331 adults were included (221 open SB, 41.2 years (12.9), 57% of women). 176 (53%) had scoliosis: 57% with open and 45% with closed SB. Individuals with scoliosis more frequently had open SB (p=0.03), cranially located SB (p<0.0001), severe neurological deficits (p≤0.02) and poorer walking ability (p <0.0001). In total, 69% had chronic back pain, with no difference in frequency between those with and without scoliosis. An asymmetrical motor level and a FAC score <4 increased the risk of scoliosis (OR=0.46, p<0.006 and OR=0.75, p<0.0001 respectively).
 

Discussion - Conclusion : These results demonstrate that scoliosis is frequent and must be considered in the assessment of all individuals with SB, including adults and those with closed SB. Individuals with an asymmetrical motor level and poor walking ability were at risk of scoliosis and should therefore be closely monitored.
 

Keywords : Spina Bifida; spinal dysraphism; neural tube defect; scoliosis; spinal deformity; myelomeningocele