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Patients with myelomeningocele have an allergic response (type 1 hypersensitivity) to latex by what cellular mechanism?
Overactive complement system
Hyperactive killer-T cells
Select Answer to see Preferred Response
An 18-year-old ambulatory female with spina bifida presents with a painful planovalgus left foot. She has failed treatment with orthoses and heel-cord stretching regimens. Ankle radiographs demonstrate that the distal tibia is tilted 15° into valgus relative to the long axis. Which of the following treatment options would best correct the deformity?
Triple arthrodesis of the ankle
Medial tibial epiphysiodesis
Calcaneal lengthening osteotomy and tendo-Achilles lengthening
Midfoot osteotomy combined with plantar release
A 4-year-old girl with an L3 myelomeningocele presents for routine follow-up. Pelvic radiographs reveal a complete dislocation of the left hip with well formed acetabulum, and a normal right hip. Her gait is symmetric with use of a walker and brace. Which of the treatment options should be offered to the patient at this time?
Right sided femoral shortening osteotomy
Continued observation and routine follow-up
Left greater trochanteric advancement
Left sided pelvic osteotomy
Open reduction of the left hip
A 6-year-old boy with spina bifida presents to your clinic with a progressive foot deformity. He can walk independently and ankle dorsiflexion and toe extension demonstrate full strength. He has a bulky, hypertrophied heel pad, but no open ulceration. Foot radiographs are displayed in Figure A. What myelomeningocele level does this patient have and what surgical procedure is indicated for the foot?
L1 level requiring triple arthrodesis
L3 level requiring triple arthrodesis
L3 level requiring posterior transfer of the anterior tibial tendon
L5 level requiring triple arthrodesis
L5 level requiring posterior transfer of the anterior tibial tendon
HPI - Patient was referred to our institution 3 months ago from another state. She has high level myelomeningocele with multiple vertebral formation failure and high grade lumbar kyphosis.
How would you treat this patient?