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Upstate Neurological Institute

Spina Bifida

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Upstate Golisano Children's Hospital

About Spina Bifida

Definition

Spina bifida (SB) is a problem with how the spine and spinal cord form before birth. It may cause structures that should be inside the spinal canal to slip out.

The three most common types are:

  • Occulta—a small defect in one or more backbones that usually does not cause health problems
  • Meningocele—membranes that poke through an open part of the spine and can form a cyst
  • Myelomeningocele—membranes that poke through and have nerve roots or spinal cord. This can lead to severe problems
Spina Bifida
Spinabifida
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Causes

The cause is not always known. It is likely due to:

  • Genetics
  • The pregnant person not getting enough folate
  • Environmental factors

Risk Factors

SB is more common in females. Other things that may raise the risk are:

  • Having other family members who have had SB
  • Parent had a prior pregnancy with a baby who had brain, spine, or spinal cord issues
  • Low blood level of folic acid in the parent when the pregnancy started
  • Diabetes in the pregnant person
  • Certain medicines given during pregnancy

Symptoms

SB occulta may not have any symptoms. Some people with this type may never know they have SB. There may be a small tuft of hair or change in skin color over the low back.

The symptoms of meningocele and myelomeningocele are:

  • A sac filled with fluid leading out from the baby's spine
  • Spinal cord and tissue that may stick out of the back

Diagnosis

Prenatal Testing

A blood test during pregnancy can predict the risk of SB. If the test predicts a high risk, then two more tests may be done:

  • Amniocentesis—a sample of the fluid around the baby is taken to measure for things that point to spine problems
  • Ultrasound—a test that uses sound waves to look at the fetal spine

After Delivery

After delivery, a meningocele and myelomeningocele can be seen. More tests will be done to find out what health problems the baby may have.

Most children with SB occulta will never be diagnosed. It rarely causes any symptoms. It also has few problems. It may be found during a routine medical exam or x-rays of the lower back.

Treatment

SB occulta does not need treatment.

Meningocele SB is treated with surgery to remove the cyst.

Treatment for myelomeningocele SB is complex. Options are:

  • Surgery to put the nerves, membrane, and spinal cord back into place before birth or soon after birth
  • Physical therapy to help muscles get stronger and to learn how to use devices like walkers, braces, and crutches to move

Prevention

The risk of having a baby with SB can be lowered by taking folic acid supplements before and during pregnancy.

References

  • Phillips, L.A., Burton, J.M., et al. Spina bifida management. Current Problems in Pediatric and Adolescent Health Care, 2017; 47(7): 173-177.
  • Spina bifida. EBSCO DynaMed website. Available at: http://www.dynamed.com/condition/spina-bifida.
  • Spina bifida. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/developmental-disabilities/Pages/Spina-Bifida.aspx.
  • Spina bifida. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/health-information/disorders/spina-bifida.
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