Overview

Children with spina bifida are prone to multiple ortho­pedic issues during the course of their lifetime. Many of the problems can be predicted by understanding the effects the neurologic deficits will have on nor­mal motor control and development.

Orthopedic complications of spina bifida are com­mon and have predictable patterns based on the neu- rosegmental level. Treatment needs to be developed in partnership with the family and child. Realistic goals of the interventions need to be discussed up front and the post-treatment plan of care developed. Surgeries often improve range of motion only to be short lived for lack of compliance with the postoperative plan. The plan often includes twice daily stretching and daily bracing and positioning.

Clinical Case. JR is a three-year-old with a history of a meningomyelocele at an L3 level. The family came in today to discuss the orthopedic issues. They feel that his hips are popping and he has a difference in his leg lengths. They also want to know if he is going to develop a scoliosis.