• FariaTereza Cristina Carbonari deTCCDepartment of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil. Electronic address: t.faria@uol.com.br., Sergio Cavalheiro, da CostaMarcos Devanir SilvaMDSDepartment of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil., Patrícia Alessandra Dastoli, Sílvia Lanziotti Azevedo Silva, Jardel Mendonça Nicácio, Italo Caprano Suriano, Maurício Mendes Barbosa, and Antonio Fernandes Moron.
• Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil. Electronic address: t.faria@uol.com.br.
• World Neurosurg. 2021 May 1; 149: e269-e273.

BackgroundIn this study, we evaluated children who underwent prenatal myelomeningocele (MMC) repair to investigate the influence of the anatomical level of the lesion on functional motor skills and congenital orthopedic malformations.MethodsThis cross-sectional study evaluated children who underwent prenatal correction. The anatomical level of the lesion was classified by observing the magnetic resonance of the spine. The sensory/motor assessment was performed by physical examination to classify the status of ambulation, functional level, and functional performance according to chronological age using the Pediatric Evaluation of Disability Inventory (PEDI-CAT) scale.ResultsOne hundred cases were evaluated; for 60%, lesions were located in the upper lumbar region and for 40%, they were located in the lower lumbar and sacral regions. The functionality, measured by the PEDI-CAT scale, showed a normal average according to age (mean 50), with 71% of children being community ambulators. Congenital orthopedic malformations were also unrelated to the injury levels, except for knee dislocation in relation to upper lumbar injury. At the functional level, we observed that for the majority, the levels of function of at least 2 vertebrae were below the anatomical level.ConclusionsThere were no differences in functional motor skills, walking pattern, or congenital orthopedic malformation when compared with the anatomical level of injury in patients who underwent prenatal repair of MMC, except for congenital knee dislocation.Copyright © 2021 Elsevier Inc. All rights reserved.

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