Spina bifida is a birth defect that affects the spine. Spina bifida can be mild enough that no treatment is necessary or the condition can be more severe and require treatment to reduce limitations caused by abnormal spinal development.
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What Is Spina Bifida?
In normal spinal development, the neural tube forms and closes early in pregnancy. In cases of spina bifida, part of the neural tube does not develop or close properly, causing defects in the spinal cord or surrounding bones. There are three types of spina bifida:
- Spina bifida occulta is the mildest form of the condition and often has no visible symptoms. Spina bifida occulta occurs when the outer part of the vertebrae fails to close. This form of spina bifida affects an estimated 10 to 20 percent of the population.
- Meningocele is the least common type of spina bifida. Meningocele is characterized by meninges, or membranes, forced between gaps in the vertebrae, usually without damaging the nervous system.
- Myelomeningocele is the most severe type of spina bifida and is characterized by an unfused portion of the spinal column through which a sac of fluid protrudes that contains part of the spinal cord and nerves.
Spina Bifida Causes
Although the complete causes of spina bifida are unknown, it is believed to be caused by a combination of genetic and environmental factors. The risk of having a child with spina bifida may be higher for women with a folic acid deficiency, obesity, poorly managed diabetes or who are on anti-seizure medication.
Women who plan to become pregnant are advised to take a folic acid supplement to minimize the chances of spina bifida developing in the fetus.
Spina Bifida Diagnosis
Spina bifida is often detected by ultrasound during pregnancy. High levels of alpha-fetoprotein (AFP) are usually followed up by an ultrasound of the fetal spine and a test of the mother’s amniotic fluid, called an amniocentesis.
If not detected during pregnancy, spina bifida can be diagnosed after birth. A dimple, birthmark or hairy patch of skin on the baby’s spine may indicate that the baby has the condition, which can be confirmed with an X-ray, magnetic resonance imaging (MRI) or a computed tomography (CT) scan.
In some cases, spina bifida is mild enough and exhibits few enough symptoms that the condition may never be diagnosed.
Spina Bifida Treatment
Because cases of spina bifida can range from very mild to severe, treatment is customized for each individual. In severe cases of spina bifida when the condition is diagnosed during pregnancy, open fetal surgery may be performed. More commonly, however, surgery is performed after delivery. Surgery for spina bifida aims to prevent further nerve damage and fasten the nerve roots and spinal cord in their correct position.
In less severe cases, treatment may be a combination of physical therapy, medication and continued monitoring of the spine as the child develops. People with bladder, kidney or bowel dysfunction as a result of spina bifida can manage their condition with a program of catheterization. Some individuals may benefit from braces, a wheelchair or other equipment for maximum mobility. With proper care, children with spina bifida can enjoy healthy and active lives.