When a Child Has Spina Bifida

What is spina bifida?
Spina bifida is a type of birth defect called a neural tube defect. In spina bifida, the spinal column doesn't close completely during early fetal development. This can leave the spinal cord, nerves and their coverings (meninges) at risk for damage.

It's not known what causes spina bifida. It may be a combination of genetic and environmental causes.

There are three forms of spina bifida:

• Occulta spina bifida. This is the mildest and most common form of the disease and often causes no serious symptoms. A small defect may be present in the bones that surround the spinal cord, but it's generally covered by several layers of skin. There may be only a dimple or hairy patch visible over the affected part of the spinal column. This is also called a closed neural tube defect.
• Meningocele spina bifida. In this form, a fluid-filled sac sticks out through an opening in the spine. The sac does not contain the spinal cord and nerves, so it usually causes little damage. Surgery can be done to remove the sac.
• Myelomeningocele spina bifida. This is the most severe form of the disease. The spine is open, and the nerves and spinal cord are exposed increasing the risk of damage and infection. Surgery can be done to close the spine, but some paralysis and bladder or bowel problems are still likely. The defect also interferes with the flow of fluid that surrounds the brain and spinal cord (cerebrospinal fluid). This may cause hydrocephalus, or "water on the brain."

Complications of spina bifida depend on where along the spinal cord the defect and nerve damage occur.

Possible complications include:

• Paralysis or weak muscles.
• Hydrocephalus. This requires surgery to place a tube (shunt) to drain the fluid.
• Bowel and bladder problems.

Other problems that can develop include infections (such as meningitis or urinary tract infections) and latex allergies. Most children with spina bifida have normal intelligence, but some have learning disabilities.

How is spina bifida treated?
Treatment depends on the type of spina bifida the child has and whether nerve or spinal damage has occurred.

• Children with mild forms may not need treatment.
• Children with more severe forms usually need surgery soon after birth. Treatment for bladder or bowel problems will be started right away. Early physical therapy can help prepare a child with paralysis to walk with braces or crutches later, but some will need a wheelchair. Some may need later surgeries.

All children with spina bifida should see their doctors for regular follow-up. This increases the chance that complications will be found and treated right away.

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External Sources National Institute of Neurological Disorders and Stroke. Spina bifida fact sheet. Accessed October 2, 2007. Spina Bifida Association. FAQs about spina bifida. Accessed October 2, 2007. March of Dimes. Spina bifida. Accessed October 2, 2007.

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