Bad reputations about miltoniopsis being difficult to grow is just wrong.
I tried my luck with them and it turned out they are about as easy as any orchids out there.
One thing is that they do not like heat although they seem to take it fine.
Another thing is watering. The new growing leaves will easily accordion if not enough water is given, so be generous with watering while they are actively growing and never allow them to dry out too long.
Once accordioned, forever accordioned! lol
I'm serious. When this accordion of leaves becomes severe, all the newer leaves inside the older leaves do not stay stuck and the whole growth gets ruined.
Other than that, it is not that fussy.
Each pb will make somewhere between 1 to 3 spikes.
It looks like you have a new spike developing.