Spina Bifida

What is it?

Spina bifida means “open spine.” The spine protects the spinal cord, which is the bundle of nerves that runs down the middle of the back. Spina bifida happens when the spinal cord or bones in the spine don’t form correctly, leaving a gap or opening. Spina bifida can happen anywhere along the spine. It is the most common kind of neural tube defect, and it can affect how a baby’s brain, spine, spinal cord and meninges develop. The four types of spina bifida are:

  • Spina bifida occulta (also called hidden spina bifida). This is the mildest and most common form, where spinal cord and nerves stay in place and most often aren’t damaged.
  • Closed neural tube defect. In patients who have this condition, the fat, bone or meninges around the spinal cord don’t form correctly. This sometimes damages the nerves in the spinal cord.
  • This is the rarest form of spina bifida. In this condition, the meninges push out through a gap in the spine, creating a sac filled with fluid called a meningocele.
  • Myelomeningocele, also called an open spina bifida is the most severe form of spina bifida. In this condition, part of the spinal cord pushes out with the meninges through the opening in the spine to form a sac on the baby’s back. The spinal cord and nearby nerves are damaged.

Symptoms

Spina bifida can cause several health problems, including:

  • Bowel problems.
  • Chiari II malformation. This condition happens when the lower part of the brain sits in the upper part of the neck. Babies who have this condition usually have myelomeningocele. Some babies also have hydrocephalus (fluid buildup in the brain), weakness or stiffness in the arms and hands, trouble feeding, breathing or swallowing
  • Extra fluid in the head can cause it to swell and put pressure on the brain.
  • Intellectual and developmental disabilities.
  • This is an infection that causes swelling in the brain and spinal cord.
  • Muscle weakness and joint pain.
  • People who have spina bifida on the upper part of the spine may have paralyzed legs or feet.
  • Skin problems. People who have spina bifida can develop sores, calluses, blisters and burns on their feet, ankles and hips.
  • Tethered spinal cord. Normally, the bottom of the spinal cord floats freely in the spinal canal (the hollow space around the spinal cord). If the cord becomes attached (tethered) to the spinal canal, the cord stretches as the baby grows. The stretching can cause nerve damage in the spine.
  • Urinary tract infections.

Diagnosis

Doctors can diagnose most types of spina bifida during the pregnancy or after the baby is born. Diagnosing spina bifida during pregnancy includes:

  • maternal blood screening test
  • amniocentesis, the test to check amniotic fluid taken from around the baby for birth defects such as neural tube defects.
  • This test uses sound waves and a computer screen to show a picture of the baby. Doctor may see spina bifida with this test.

Diagnosing spina bifida after the baby is born:

  • In most cases, the occurrence of spina bifida is visible immediately after the child is born. Doctors may use one of these tests to get a clearer view of baby’s spine: Computed tomography (CT), magnetic resonance imaging (also called MRI), and X-ray.

Treatment

In babies with spina bifida, nerves and membranes can push out of an opening in the spine and form a sac, which damages the nerves and can lead to serious infections, so the baby will usually have surgery to repair the spine within 48 hours of birth. During surgery, the surgeon will put the spinal cord and any exposed tissues or nerves back into the correct place. The gap in the spine is then closed and the hole sealed with muscle and skin. Although this will repair the defect, it cannot reverse any nerve damage.