Orthoteers homepage Advertise on Orthoteers
Orthoteers Junior Orthoteers Orthopaedic Biomechanics Orthopaedic World Literature Society Educational Resources Image Gallery About Orthoteers Orthoteers Members search

Neuromuscular disorders

1. (Myelodysplasia)

Congenital disorder of development of posterior vertebral arch and or spinal cord, lumbo/lumbosacral area.

Incidence laminar defects 5%, cystic 2-3/1000 live births. If one child affected risk increased by ten times

Screening serum alphafeto protein, ultrasound. Folic acid for peri pregnant women


Spina bifida occulta-

  • midline defect in lamina, may have overlying dimple or hairy patch. 

  • Occasional intraspinal anomalies, tethering of conus medullaris, diastomatomyelia, cysts/lipomas of cauda equina

    Spina bifida cystica-

Spina bifida cystica-

  • Prolapse of CSF filled meningeal sac = meningocoele

  • Lipoma in sac with neural elements intertwined = lipomeningocele

  • Prolapse of sac containing spinal cord and nerve roots = myelomeningocoele

  • If cord in primitive state, neural plate forming roof of sac = open myelomeningocoele = rachischisis



  • Distal tethering of cord may cause herniation of cerebellum through foramen magnum causing a CSF block (70% of spina bifida get this)

    Neurological dysfunction

Neurological dysfunction

  • myelomeningocoele always ass with neurological dysfunction below level

  • occulta occ. ass with less severe neurological dysfunction



  • isolated laminar defects often in clinically normal people

  • hairy patch, dimple naevus, signifies more serious disease

  • May present at any age with neuro symptoms, Cauda equina or weakness

  • Xrays show laminar defect. Bony midline ridge suggests diastomatomyelia

  • Intra spinal lesions shown on MRI


  • Obvious defect at birth. Abnormal baby posture in utero - muscle imbalance, hip dislocation, talipes, claw toes

  • 1/3rd = complete lower motor neuron paralysis and loss of sensation and sphincter control below level

  • 1/3rd = complete lesion at some level but distal segment of cord preserved- intact upper motor neuron lesions below

  • 1/3rd = cord lesion incomplete so some movement and sensation preserved

This is a preview of the site content. To view the full text for this site, you need to log in.
If you are having problems logging in, please refer to the login help page.

© 2005-2007 Orthoteers.co.uk - last updated by Len Funk on 09 February 2005Medical Merketing and SEO by Blue Medical 
Biomet supporting orthoteersThe British Orthopedic Association supporting OrthoteersOrthoteers is a non-profit educational resource. Click here for more details
Lower Limb
Paediatric Spine
Arthritis in Children
Bibliography, Links & Recommended R...
Birth injuries
Cerebral palsy
Cerebral Palsy - Treatment
Childhood Upper extremity problems
Eastwood / Cole Method
Ellis-van Creveld Syndrome
Fracture Principles in Paediatrics
Gait abnormalities
Genetic disorders
Haematopoietic Disorders
Hereditary Sensory & Motor Neur...
Klippel-Feil syndrome
Metabolic disease
Metaphyseal Chondrodysplasia Case
Neuromuscular disorders
Orthopaedic embryology
Orthopaedic infections in children
Orthopaedic infections in children ...
Osteogenisis Imperfecta
Skeletal dysplasias
Hide Menu