Spinal problems in myelomeningocele-orthotic principles.

Spinal curvatures associated with myelo­ meningocele represent complex problems which, if no t recognized early, determine the future ambula tory status of the patient. In recognizing the importance of functional spinal alignment, it is manda tory to supervise closely a child from infancy and to institute early protective care (Bunch et al., 1972). Spinal problems are not necessarily evident a t birth. Sharrard (1972) reported that 75 per cent of the myelomeningocele patients examined a t bir th showed no spinal abnormali ty. A n earlier study conducted at Newington Children's Hospital (Raycroft and Curtis, 1972) reported comparable findings. It is of interest tha t in this study 79 per cent of the 130 patients involved h a d bony defects limited t o the posterior