Effect oi Selected Pltysical Therapy Program on Bone Mineral Density in Myelomeningocele

Abstract

Spina bifida or myelodysplasia is a congenital abnormality in which there is a developmental defect in the spinal column with incomplete closure of fusion of the vertebral arches. There may or may not be protrusion and dysplasia of the spinal cord or its membranes (Shepherd, 1995). Myelodysplasia is a part of a spectrum of deformities resulting from failure of closure of the neural tube late in the first month following conception. (Staheli, 2001). Myelomeningocele involves spinal cord, nerve roots and meninges, all of which may protrude through the vertebral defect. The defect can occur at any level of the neuraxis but is most common in the lumbosacral area. It is the child with myelomeningocele who most concerns the physiotherapist (Petersen, 1992). Since the 1960s,the falling mortality rate of patients with myelomeningocele has allowed increasing number to survive into adolescence and early adulthood. Among the many new challenges faced by these patients are osteoporosis and pathologic bone fractures, the frequency and severity of such bone fractures in patient with myelomeningocele has been well documented by a number of orthopedists caring for those children, Quilis reported 55 fractures of the lower extremities occurring in 15 of 130 children (Quilis, 1974).