Orthopedic aspects of myelodysplasia in children

A review of new developments in spina bifida shows that many cases are preventable by administration of periconceptual folic acid, reducing the relative risk by up to 86%. Currently, however, 50% of women of reproductive age have no folic acid in their usual diet. The Centers for Disease Control has recommended folic acid at 0.4 mg/d for all women anticipating pregnancy. The long-term outcomes of sacral level patients show a surprising decline in adult ambulatory status. Adult ambulatory status in spina bifida is significantly predictive (89% accurate) by two variables: motor level and sitting balance. Studies regarding hip dislocation, foot deformities in thoracic level children, the prevalence of spondylolisthesis, and surgical treatment of kyphosis are also reviewed.