Physical Medicine and Rehabilitation Department, University Children's Hospital, Belgrade, Serbia.
Arch Med Sci. 2011 Dec 31;7(6):1049-54. doi: 10.5114/aoms.2011.26619. Epub 2011 Dec 30.
Patients with spina bifida in the lumbosacral region usually have various degrees of motor and sensory dysfunctions of the lower extremities and anal sphincter. The aim of our study was to evaluate the distribution and differences in frequencies of affected muscles, number of affected muscles and degree of neurogenic lesion between patients with spina bifida occulta (SBO) and spina bifida aperta (SBA).
In 100 patients with SB, 6 muscles in the lower limbs were separately analysed. Due to the number of affected muscles, we evaluated 5 groups of patients: with 1 affected muscle, 2 affected muscles, 3 affected muscles, 4 affected muscles and 5 affected muscles. Three degrees of neurogenic lesions were assessed: mild, moderate and severe.
The tibialis anterior muscle was most frequently affected in SB patients. The outer anal sphincter was frequently affected in the group of SBA patients. Single muscle affection is frequent in the group of patients with SBO, while in the group of patients with SBA, 4 muscles were significantly frequently affected. The great majority of patients (45.46%) with affected outer anal sphincter (OAS) in the group of SBO were without affection of other muscles, while for the SBA group it was for every third patient. Mild neurogenic lesion was significantly frequent in SBO patients, while severe form was significantly frequent in SBA patients.
Patients with SBO usually present with mild to moderate clinical presentation, while multiple root involvement and severe degree of neurogenic lesion is associated more frequently with SBA.
腰骶部脊柱裂患者常伴有不同程度的下肢运动和感觉功能障碍及肛门括约肌功能障碍。本研究旨在评估隐性脊柱裂（SBO）和显性脊柱裂（SBA）患者受累肌肉分布和频率差异、受累肌肉数量及神经源性损伤程度。
在 100 例 SB 患者中，分别分析了 6 条下肢肌肉。由于受累肌肉的数量，我们评估了 5 组患者：单肌肉受累、2 肌肉受累、3 肌肉受累、4 肌肉受累和 5 肌肉受累。评估了 3 种神经源性损伤程度：轻度、中度和重度。
在 SB 患者中，胫骨前肌最常受累。在 SBA 患者中，外肛门括约肌常受累。单肌肉受累在 SBO 组患者中较为常见，而在 SBA 组患者中，4 肌肉受累则更为常见。在 SBO 组中，有 45.46%的外肛门括约肌（OAS）受累患者无其他肌肉受累，而在 SBA 组中，每 3 例患者就有 1 例出现这种情况。SBO 患者中轻度神经源性损伤较为常见，而 SBA 患者中重度神经源性损伤较为常见。
SBO 患者通常表现为轻至中度临床症状，而多发性神经根受累和严重程度的神经源性损伤更常与 SBA 相关。
