Motor function outcomes in children with open prenatal repair of Spina Bifida Aperta at 36-month follow-up: The Zurich cohort.
Brittany Brun, David A Wille, Sonja M Schauer and 4 others
PMID 38160370WHAT IT FOUND
At 36 months, 86% of children after prenatal spina bifida repair were walking, but most needed orthotics or assistive devices.
Walking was delayed, and children with lower motor function levels walked more often.
Key findings
01At 36 months, 86.0% of children were walking, but 61.6% needed orthotics or assistive devices and 24.4% walked without aids.
02Motor function level at 36 months was associated with ambulation: all 21 children with an L5 or sacral level were walking.
03Walking onset differed by motor level: 75.0% of children with L5-S1 levels walked by 24 months and 100% by 36 months, compared with 34.8% and 76.1% for children with L2-L4 levels.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
There was no postnatal repair comparison group, so the study cannot show that prenatal repair caused the ambulation outcomes. The cohort came from one center and included children only from Europe and Russia, so results may not apply to other settings or ethnic groups. Follow-up was only to 36 months, so longer-term ambulation during growth is unknown. Motor function level assessment in young children can be imprecise and subjective. Different studies use different functional level classifications, so comparison with other cohorts is difficult. Ambulation groups were uneven and some were small, so statistical testing for predictors was not possible. Physical therapy type and frequency varied widely across countries, so the study cannot evaluate which therapy was used.
The easy way to misread this
Do not read the 86% walking rate as proof that prenatal spina bifida repair causes better motor function. This was a single-center cohort without a postnatal comparison group, and most ambulators still needed orthotics or assistive devices.