Spina Bifida

Spina bifida is a congenital neural tube defect where there is an incomplete closing of the backbone and membranes around the spinal cord. Normally, the neural tube forms early in the pregnancy and closes by the 28th day after conception.

Spina bifida is a congenital defect as a result of an insufficient development of baby’s spine and spinal cord in the womb, causing a gap in the spine.

The severity of this birth defect can vary to a large extent meaning that this gap can be so small that it does not cause any significant or visible problems or it can be so big that it can be a cause of a significant amount of disability.

Spina Bifida

Spina bifida can developed anywhere on the spine, on one or more vertebrae, but it is most common on the waist level. In most cases it develops on the thoracic, lumbar or sacral segment of the spine and usually includes 3 to 6 vertebrae.

The severity of spina bifida is graded from spina bifida occulta (without any visible defects) to visible defects like those including a sac or cyst (spina bifida cystica) and an entirely open spinal cord (rachischisis) with serious neurological consequences and possible death.

Such a cleft can also have a negative impact on the bladder, causing a vesicoureteral reflux and hydronephrosis, frequent urinary infections and ultimately an irreversible kidney damage. Where this medical condition is concerned, the prognosis depends on the severity of spina bifida and other medical issues caused by it. However, a special care is a presupposition of success.

Frequently asked questions

How many types of spina bifida are there?

Spina bifida cystica or myelomeningocele (Meningocele) is the most serious and more common of the two forms of cystic spina bifida. The visible signs are a sac or cyst, rather like a large blister on the back, covered by a thin layer of skin. Pigmented marks or hair on the damaged area are also a possible.

With this type of spina bifida, the cyst not only contains tissue and cerebrospinal fluid but also nerves and part of the spinal cord. As a result, there is always some paralysis and loss of sensation below the damaged region, as well as problems with bowel and bladder movement control. In 70-90 % of cases of spina bifida, hydrocephalus is usually associated with it. There are collections of cerebrospinal fluid accompanied with a disbalance in swelling. As a consequence, babies have significantly larger heads. This fluid can put pressure on the brain and impair normal development.

Meningocele is a less serious and a more rare type of a spina bifida cystica. There is a collection of cerebrospinal liquid, but an impairment is usually less severe than with myelomeningocele.

Spina Bifida Occulta - This type of spina bifida is known as a ‘silent’ spina bifida since 15 % of people are not aware that they have it. Often, people only become aware that they have spina bifida occulta after having a back x-ray for an unrelated problem. It does not have any visible defect apart from a mole or a hole that sometimes appear and for the vast majority of those affected, having spina bifida occulta is of no consequence whatsoever. The spine as well as nerves are mostly intact and the pain and mild neurological problems are rare symptoms.

However, symptoms like turning in of the feet, numbness or lack of sensation on legs and arm movements, frequent urinary infections or bowel movement disbalances are possible.

Encephalocele – This is a sac which is formed when the bones of the skull fail to develop. It may contain only cerebrospinal fluid or part of the brain may also be present in the sac, resulting in brain damage. Life expectancy largely depends on a surgical procedure with mental deformities as side-effects.

Anencephaly is a type of spina bifida where the brain does not develop properly or is absent, and the baby is either still born or dies shortly after birth.