CLINICAL PEARLS

■ Scoliosis associated with spina bifida can occur at any neurologic level, but is most common in the higher lesions. Thoracic and high lumbar levels almost always develop these spinal deformities.

■ Hip dislocations are most common in the L3 level based on muscle imbalances of hip flexion and adduction being present while the opposing muscles are weak or absent.

■ Foot deformity treatment is geared toward developing a plantar-grade foot and minimizing pressure areas.

Figure 9.10 shows scoliosis noted in a child with lumbar level meningomyelocele.

Figure 9.10 Scoliosis noted in child with lumbar-level meningomyelocele.