Spina Bifida Levels

Thoracic

 

Function

- no hip flexion

- no voluntary leg movement

 

Effect

- no ambulation

- hip flexed and ER

- feet equinovarus

 

L1

 

Function

- grade 2 psoas

 

Effect

- no ambulation

- hip adducted and flexed

- feet equinovarus

 

L2

 

Function

- grade 3 psoas

 

Effect

- hip adducted / flexed

- knee flexed

- feet equinovarus

 

L3

 

Function

- grade 3 quads

 

Effect

- hip adducted and flexed / highest risk hip dislocation

- household ambulator only with KAFO

- knee recurvatum / no hamstrings

- foot equinovarus

 

L4

 

Function

- > grade 3 quads

- medial hamstrings

- tibialis anterior grade 3

- AFO

 

Effect

- hip adducted / flexed

- reasonable ambulation with AFO

- knee extended

- foot cavovarus

 

L5

 

Function

- lateral hamstrings

- grade 3 abductors

 

Effect

- hip flexed but not adducted

- community ambulator in AFO

- calcaneocavus foot

 

S1

 

Function

- grade 3 power T achilles

 

Effect

- claw toes, poor sensation

- still get calcaneus as weak T Achilles