SPINA BIFIDA MANIFESTA ORTHOPEDIC PROBLEMS AND THE ANALYSIS OF AMBULATORY FUNCTION

1) The interest in the spina bifida children with higher rehabilitation potential than C. P. is increasing recently in Japan. 2) From 1970, over one hundred spina bifida children visited Kanagawa Children's Medical Center. We are approaching them from several aspects. The problems of orthopedic surgery and habilitation are reported in this paper including ambulatory function. 3) The management of deformities of spine and lower extremities shoud be done under the proper understanding of their developing mechanism. 4) We classified the level of paralysis into six groups according to the lowest level of the nerve preserved. The patients with intakt L5 show no paralytic hip dislocation and have independent ambulation with or without short leg braces. 5) Therefore, L5 nerve is seemed to be the critical level for the spina bifida children. 6) The children with the paralysis below this level can get indipendent ambulation until the age of three to four by proper management.