Risk factors for pressure sores in adult patients with myelomeningocele – a questionnaire-based study

A structured questionnaire regarding sores, medical condition, function and living factors was designed and sent to the 193 patients with MMC registered in the year 2003 at TRS, a National Centre for Rare Disorders in Norway.Out of 193 total, 87 patients participated and 71 patients (82%) reported sores; 26 (30%) at the time of the interview and 45 (52%) during the last 5 years. Sores were mostly localized on toes and feet and occurred exclusively in regions with reduced or missing sensibility. A significant association was found between sores and memory deficit (p = 0.02), Arnold Chiari malformation (p = 0.02) and a record of previous sores (p = 0.004). Sores were not significantly associated with hydrocephalus, syringomyelia, nutrition, body mass index, smoking, physical activity, employment or living together with other persons. Some patients (18, 21%) reported skin inspection by others and the remainder relied on self-inspection.Patients with sensory deficit, memory problems, and Arnold Chiari malformation had a higher risk of having pressure sores. This patient group needs improved skin inspection routines and sore treatment.Myelomeningocele (MMC) is a complex congenital spinal anomaly that causes varying degrees of spinal cord malformation, or myelodysplasia. It is a developmental defect in the formation of the neural tube from the embryonic neural plate, and as such is a disorder of the cerebrospinal fluid system. It is commonly referred to as spina bifida, although this term originally described only a malformation of the spine and not of the neurological structures. In this paper we use the term MMC, because it focuses on the neurological structures. In addition, MMC is often associated with tethered cord and an abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. Hydrocephalus is the most common anomaly, which occurs in more than 90% of infants with MMC [1]. MMC may be associated with the Arnold Chiari mal