Spina bifida happens early in pregnancy when the developing spine does not close properly. Infants born with spina bifida can have an open area on their back where nerve damage can occur. There are 3 types of spina bifida.
- Spina bifida occulta: the bones in the back of the spine do not properly form, but there is no nerve damage present. There can be a dimple or hairy patch present on the back over the area.
- Meningocele: there is a fluid filled sac outside the skin, but no nerve damage occurs.
- Myelomeningocele (MM): the most severe form, where the spinal cord and nerves form outside the body. Most children have weakness and loss of feeling in their legs. They can also have problems with bowel and bladder function.
The exact cause of spina bifida is unknown. Mothers who do not take enough folic acid (a common B vitamin) are more likely to have children with spina bifida. Prenatal vitamins contain folic acid and other common vitamins important for the developing child.
Women who are pregnant or are considering getting pregnant should take Folic acid supplements. This can reduce the risk of spina bifida by 70%.
Most children with MM or meningocele are diagnosed while in the womb during routine ultrasound or blood tests. Milder cases can be diagnosed after birth if the baby has a hairy patch at the bottom of the back. Patients with myelomeningocele have trouble feeling and moving their legs. They can also have tight joints that do not bend well. Many patients have a foot that is bent down and inward, known as a clubfoot. Spina bifida occulta does not have any symptoms and may never be diagnosed unless an x-ray is taken.
Children with spina bifida occulta may never have any symptoms and do not need special tests. However, children with MM and meningocele can have many problems and need specialty care. This can include orthopaedic surgeons, neurosurgeons, urologists and rehabilitation specialists.
There is no cure for spina bifida. Nerves in the spinal cord that have been damaged cannot be repaired. Treatment is aimed to help children walk or sit better in a wheelchair. Many children will need braces, crutches or other aids to help them walk.
Children with spina bifida and MM may need surgery to help them walk or sit better. Some children will need surgery on their back to straighten an abnormal curvature of their spine, known as kyphosis and/or scoliosis. Hip surgery is also common to help keep the hips positioned correctly. Many children with MM have a clubfoot, where the foot is turned inward and downward. Sometimes this can be corrected with casts and other children may need surgery to position their feet forward. Children with MM may also have problems with a tethered spinal cord or difficulty with bladder function. An allergy to latex products may develop due to repeated exposure to latex during bladder catheterization. They may need surgery to release the spinal cord as they grow, or surgery to help them use the bathroom easily.
Q: What is spina bifida?
Spina bifida is a condition where the back of the spine does not form correctly.
Q: Are there different types of spina bifida?
Sometimes the back of the spine has a small gap, called spina bifida occulta. Other times the gap is larger, and spinal cord fluid can protrude outside of the spine. This is called a meningocele. If spinal nerves are pushed out into this sac this can lead to spinal cord problems and nerve damage. This is known as myelomeningocele (MM).
Q: What causes spina bifida and myelomeningocele?
The exact cause is not known. Mothers who do not have enough folic acid (a common B vitamin) are more likely to have children with these conditions.
Q: Can spina bifida be prevented?
Women who are pregnant or are considering getting pregnant should take prenatal vitamins and/or Folic acid supplements. This can reduce the chance that the child will develop spina bifida by 70%.
Q: How is spina bifida diagnosed?
Spina bifida occulta is sometimes diagnosed when the child has a hairy patch or dimple over their lower back. Otherwise it is noticed when the child has a spine or hip X-ray for another problem. It is very uncommon for the presence of a spina bifida occulta to be associated with any problems and it is usually found as a coincidence because an X-ray of the spine was obtained.
Q: How is myelomeningocele diagnosed?
MM is often diagnosed while the baby is in the womb using blood test or a prenatal ultrasound. Milder cases that miss this initial screening are detected after birth.
Q: Will my child be able to walk?
Children with MM often have tight joints and weak muscles. The ability to walk depends on how many nerves are involved in the myelomeningocele. Many children will need casting or braces to help them walk.
Q: Will my child need surgery?
Children with spina bifida occulta do not typically need surgery. Children with MM may need spine surgery, hip surgery or leg surgery to help them walk or sit better.