Lumbar canal stenosis: a cause of late neurological deterioration in patients with spina bifida.

BACKGROUND

Patients diagnosed with spina bifida may show late deterioration. This worsening in their clinical symptoms has been attributed to a multiplicity of causes such as secondary tethering of the spinal cord, Chiari II anomaly, hydromyelia, diastematomyelia, arachnoid cysts, and dermoid tumors.

METHODS

We searched the clinical records of patients diagnosed with spina bifida who were treated at our hospital for a period of 25 years for the purpose of ascertaining the number and etiology of cases of late neurological deterioration.

RESULTS

Six of 144 patients with open spina bifida presented with late neurological deterioration. In one of these cases and in another patient with occult spina bifida the most relevant factor noted during surgery was the presence of marked lumbar canal stenosis.

CONCLUSION

We suggest that certain cases of late clinical worsening in spina bifida patients are because of lumbar canal stenosis and that this condition should be added to the list of causes that may produce delayed neurological deterioration in patients with spinal dysraphism.