Upper extremity dysfunction in children with myelomeningocele.

A retrospective chart review of 138 subjects with myelomeningocele was performed to determine factors affecting upper extremity function in this population. Upper extremity dysfunction was found in 62 subjects (46.6%). A relationship was found between upper extremity dysfunction and hydrocephalus. Subjects with hydrocephalus had a significantly greater incidence of upper extremity dysfunction than subjects without hydrocephalus. No significant relationship was found between surgically treated versus spontaneously arrested hydrocephalus or number of shunt revisions and upper extremity dysfunction. A relationship was found between level of lesion of the spinal cord and upper extremity dysfunction. High level lesions had a significantly higher incidence of upper extremity dysfunction. Of 62 patients with upper extremity dysfunction only 3 (3.2%) had normal development. This was statistically significant. Little attention has been given to general developmental status in myelomeningocele children with upper extremity dysfunction. This study suggests a strong correlation between these two variables. In conclusion, hydrocephalus, level of spinal cord lesion, and developmental status, appear to be significant factors affecting upper extremity dysfunction in children with myelomeningocele.