Caudal regression syndrome (CRS) is a congenital disorder which is seen vertebral anomalies in varying degrees from lower thoracic spineto the level of the coccyx. We present a case of CRS which is not intended operation for orthopedic deformities considering functionality. 2, 5 year-old girl referred to our clinic with complaints about walking disability, knee and foot deformities. Patient's mother with unregulated diabetes did not have a history of drug use, radiation exposure and serious illness during pregnancy. Diagnosis had been put during antenatal follow-ups. On physical examination, her lower extremities were hypoplastic and had no muscle activity. Her hips were flexed and abducted, but did not have contractures. Her knees had 75 degrees of flexion contractures with popliteal webs and feet had equinovarus deformity. Frog belly was present due to abdominal muscles weakness. Also hypoplasic labia majora has been identified. In lumbar MRI, spinal cord was terminated at 6th thoracic (T6) vertebrae and the last solid vertebrae level was at T10. Patient who has been following by urology with clean intermittent catheterization had also severe urological problems including horseshoe kidney, neurologic bladder, vesico-ureteral reflux and grade 2 hydronephrosis. Orthopedic consultation was made for her deformities. They decided that ambulation unexpected patient's knee flexion contractures were helping sitting balance. Because of this operation was not considered. Prognosis, treatment options, strength exercises for upper extremities, skin care were told to parents and patient was taken to follow. CRS is a rare congenital abnormality which is associated with orthopedic deformities, as well as urological, anorectal and cardiac malformations. Treatment requires a multidisciplinary approach. It should not be forgotten that purpose of rehabilitation is not to correct all deformities but increase the functionality of everyday life.
[Purpose] To observe motor and functional progress of children with cerebral palsy during
2 years. [Subjects and Methods] Pediatric cerebral palsy patients aged 3–15 years (n =
35/69) with 24-month follow-up at our outpatient cerebral palsy clinic were evaluated
retrospectively. The distribution of cerebral palsy types was as follows: diplegia (n =
19), hemiplegia (n = 4), and quadriplegia (n = 12). Participants were divided into 3
groups according to their Gross Motor Functional Classification System scores (i.e., mild,
moderate, and severe). All participants were evaluated initially and at the final
assessment 2 years later. During this time, patients were treated 3 times/week. Changes in
motor and functional abilities were assessed based on Gross Motor Function Measure-88 and
Wee Functional Independence Measure. [Results] Significant improvements were observed in
Gross Motor Function Measure-88 and Wee Functional Independence Measure results in all 35
patients at the end of 2 years. The Gross Motor Function Measure-88 scores correlated with
Wee Functional Independence Measure Scores. Marked increases in motor and functional
capabilities in mild and moderate cerebral palsy patients were observed in the subgroup
assessments, but not in those with severe cerebral palsy. [Conclusion] Rehabilitation may
greatly help mild and moderate cerebral palsy patients achieve their full potential.
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