Sixty-eight patients born with a myelomeningocele were studied in the
second and third decades of their lives. All of them had had some
orthopaedic surgery, an orthotic program, and other specialized medical and
paramedical services. In the group with sacral-level lesions, half were
community ambulators; in the group with lower lumbar lesions, a third; in
the group with upper lumbar lesions, a tenth; and in the group with
thoracic-level lesions, none. The most important factors that determine the
ambulatory status of a child with myelomeningocele, besides the level of
the lesion, are the motor power within a given neurosegmental level and the
extent and degree of orthopaedic deformities.