​Because the legs of children with spina bifida often do not have much (or any) strength, the bones in the legs and muscles may not develop properly. Stiff joints, or muscle contractures occur in the feet, knees and hips affecting brace wear or good sitting positions in a wheelchair. 

The orthopedic surgeon's role is to help the children maximize their potential for walking (with or without aids) or independent wheelchair use. This often means multiple surgeries to reduce the muscle contractures in the legs, or back surgery to correct a scoliosis deformity often seen in these children.
 
Dr. Alvarez and Dr. Beauchamp are the consulting orthopedic surgeons for the spinal cord clinic. There are about 300 BC children with spina bifida who attend the clinic annually.​