SCOLIOSIS AND HYDROCEPHALUS IN MYELOCELE PATIENTS - EFFECTS OF VENTRICULAR SHUNTING

Developmental scoliosis is a common cause of increasing disability and deformity in long-term myelocele survivors, and is believed to result from a paralytic collapsing spine. The possible etiological role of compensated hydrocephalus and hydromyelia was assessed by determining the effect of ventricular shunting on 11 myelocele patients with developmental scoliosis. After successful shunting, one patient with a 47° curve continued to deteriorate. Three cases with curves greated than 60° were stabilized for short periods, but eventually required spinal fusion. Seven cases with curves less than 55° were improved from a mean scoliosis of 29° to 13° during a 20-month follow-up period. Several patients had pre-existing shunts that were found to be non-functional on shuntogram. These findings suggest that the spinal complications of hydrocephalus may be more common than previously recognized in myelocele patients and that advanced developmental scoliosis may be avoided by early recognition and ventricular shunting.