« Back to Spinal Disorders

Spina Bifida Info: Definition Causes Risk Factors Symptoms Diagnosis Treatment Prevention

There are three kinds of spina bifida:

	Occulta
	- The least severe form
	- No symptoms
	- Small defect in one or more vertebrae
	- Spinal cord and nerves are normal
	- Usually no complications
	Meningocele
	- A cyst made up of membranes pokes through the open part of the spine
	- Spinal fluid can leak out
	- The cyst can be surgically removed
	- Development after surgery is usually normal
	Myelomeningocele
	- This is the most severe form of spina bifida.
	- A cyst made up of membranes, nerve roots, and sometimes the spinal cord itself pokes through the open spine.
	- Substantial problems including paralysis and incontinence of bowel and bladder often persist even after surgery.

return to top

Causes

The cause of spina bifida is unknown. Like most congenital abnormalities, there is a strong hereditary component.

return to top

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Most risk factors for spina bifida are related to the mother's health. Risk factors include:

	Low maternal blood level of folic acid at the time of conception
	Family history of spina bifida
	A mother who had a previous pregnancy with a neural tube defect
	Mother's race: Hispanic or Caucasian of European origin
	Certain medications given during pregnancy

return to top

Infants and children with spina bifida may experience the following long-term symptoms:

	Bowel and bladder problems
	Frequent urinary tract and other infections
	Learning disabilities
	Accumulation of fluid in the brain (hydrocephalus)
	Scoliosis
	Latex allergy (from frequent surgeries early in life)
	Inability to walk
	Muscle weakness and paralysis of the lower extremities
	Hip dislocation
	Foot and ankle deformities. Many children with myelomeningocele are wheelchair bound.

return to top

Diagnosis

The possibility of spina bifida can be evaluated before birth using a blood test called the maternal serum alpha-fetoprotein (MSAFP) screening test. If this test predicts a high risk of neural tube defects, your doctor will perform two more tests:

	Amniocentesis — insertion of a needle into the abdomen to remove a sample of amniotic fluid. Levels of MSAFP and other substances in the amniotic fluid are measured.
	Ultrasound — a test that uses sound waves to examine structures inside the body. In this case, the fetal spine is examined.
	Prenatal diagnosis can help you and your doctor plan for a specially equipped delivery room for quick surgery after birth. It can also give you some time before delivery to learn more about spina bifida and how to care for your child.
	After birth, meningocele and myelomeningocele are apparent on physical exam. Many tests will be required to determine the extent of internal deformities to the skeleton and nervous system. Function of the kidneys, which often become damaged, also needs to be monitored closely.
	Most children with occult spina bifida will never be diagnosed. However, some will become aware of their condition when evaluated for low back pain or other spinal conditions later in life.

return to top

Treatment

Occulta spina bifida requires no treatment.

Meningocele spina bifida is treated with a simple surgery to remove the cyst, after which the child usually develops normally.

Treatment for myelomeningocele spina bifida may include:

	Surgery
	Extensive surgery is performed on the baby 24-48 hours after birth. During surgery, the nerves, membrane, and spinal cord are put back into the spine and covered with skin. Prompt surgery can prevent further nerve damage but cannot reverse damage that has already occurred. More serious forms of spina bifida may require more surgeries throughout childhood.
	Physical Therapy
	Therapists teach parents how to exercise the infant's legs and feet. Walkers, braces, and crutches will often be required for mobility.
	Ongoing Treatment
	Complications of spina bifida can be ongoing and extensive. It will be important for you to work with a team of doctors who can provide the best care and support for you and your child. Team members may include:
	- Neurosurgeons
	- Orthopedic surgeons
	- Urologists
	- Rehabilitation experts
	- Physical therapists
	- Psychologists
	- Social workers

return to top

Prevention

To help reduce the chance that your baby will be born with spina bifida:

	Eat foods rich in folate, including:
	- Leafy green vegetables
	- Orange juice
	- Beans
	- White flour products and cereals fortified with folate
	Supplement your diet with at least 400 micrograms of folic acid every day if you plan to conceive. Continue the supplement through your pregnancy.
	Plan your pregnancies and talk to your doctor if you have any of the risk factors listed above.

Copyright© 2000 HealthGate® Data Corp. All rights reserved.

return to top