The level of the lesion provides a good estimate of the extent of lower limb functioning. (see diagram and chart below)

Of course, every individual is different, and each person with spina bifida is affected slightly differently.

Because nerves are affected at and below the point at which malformation occurs, the higher up the spine it occurs, the greater the paralysis (immobility) of the lower limbs will be. Conversely, the uncommon lesions in the high thoracic and cervical areas usually do not always indicate lower limb paralysis.

Most people with spina bifida will need leg braces or more help to walk. Braces can help to support and protect weak muscles or joints.

Sometimes people will use braces or crutches for short distances, and use a wheelchair when they are more likely to get tired or want to leave their hands free.

Most individuals will need one or more orthopaedic (bone or joint) operations over the course of their life to assist in maximising function.

The level of paralysis should not change as the person with spina bifida gets older. A range of problems, however, commonly occur throughout life. These include:

scoliosis (spinal curving due to muscle imbalances) which requires surgery.
tethered cord (the scar tissue where the lesion has been repaired "sticks", not allowing the spinal cord to move) which causes a range of problems and also requires surgery.

Lesion level and its effect on mobility

Lesion Level Effect on Mobility
T12 & above With braces, can only walk short distances; with walker or crutches, slightly longer. Will mostly use a wheelchair, even in childhood.

L1 - L3 Leg braces with a waistband; will use crutches. Wheelchair for distances

L4 Will usually need braces, perhaps above the knee; crutches or cane; wheelchairs when older
L5 - S Short leg braces; may need crutches or cane.

 

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