What is the most common foot deformity in thoracic and high lumbar spina bifida?

• A. Talipes equinovarus (clubfoot)
• B. Pes planus
• C. Pes cavus
• D. Metatarsus adductus

Answer: (A)

The main concept is that neurogenic foot deformities from high-level spinal dysraphism produce a characteristic clubfoot pattern. When the lesion is high in the thoracic or upper lumbar region, the muscles that lift and stabilize the foot are weakened or paralyzed, while the stronger plantarflexors and invertors pull the foot into a combination of plantarflexion (equinus), inward turning (varus), and forefoot adduction. This creates the rigid, multi-plane deformity known as talipes equinovarus, or clubfoot, which is the most common foot deformity seen in thoracic and high lumbar spina bifida.

Other options describe foot shapes that are less typical for this condition. Pes planus (flatfoot) involves loss of the arch and a different balance of forces, and pes cavus (high-arched foot) or metatarsus adductus are patterns usually associated with other situations or early infancy, not the predominant neurogenic pattern in these spinal lesions.