Hip surgery in the lumbar level myelomeningocele patient.

The ambulatory status of 74 patients with myelomeningocele, 4 years of age or older (average, 10 years, 5 months) was examined to assess the effectiveness of surgery about the hip in improving function. Seventeen of these 74 patients, all with lumbar levels of function, underwent surgery for the purpose of reducing a subluxation or a dislocation. Reduction of a dislocated hip did not improve function, and the failure rate was high (45% redislocation). There was little difference between the nonoperated and operated groups regarding ambulatory capabilities or the percentage of ambulators with a dislocated hip. The most severely impaired patients were those who had complications following hip surgery. The level of the neural deficit was the most important factor in determining ambulatory function.