Ηip dysplasia in children with spina bifida after prenatal surgical closure

Hip dysplasia, subluxation, and dislocation are common among children with spina bifida and can affect positioning, mobility, personal care, and cause pain. Previous research has reported high rates of hip displacement during childhood in this demographic. These changes, however, are different from developmental dysplasia of the hip, in which the hip joint is abnormally developed already at birth. Prenatal surgery for spina bifida aims to repair the spinal defect before birth and has been associated with improved neurological and motor outcomes in selected children. While radiological hip development has been studied in the past, there is currently no data available on hip development at birth for children with spina bifida in general. We therefore analysed prospectively collected data from a specialized spina bifida centre to describe their early hip status. Among 168 children who underwent prenatal closure and had standardized neonatal hip ultrasound examinations, 17 of 336 hips (5.1%) had hip dysplasia, affecting 10.7% of children. Worse hip status was associated with a higher functional level of spina bifida, while no association was found with gestational age at birth.