Spina bifida

Spina bifida occurs when the spinal column fails to close before birth. A gap between bones allows spinal membranes or even the spinal cord to bulge out. The bulge may form an external sac or an open wound, usually near the base of the spine.

If the spinal cord protrudes, there may be total paralysis of the legs. The infant may not have bowel or bladder control and has a risk of kidney failure. Rarely will an infant be mentally disabled. If only the spinal membranes protrude, chances are good that the patient can lead a normal life. Spina bifida, with a sac or open wound, is usually obvious at birth. The majority of cases of spina bifida actually go unnoticed because there is no bulging material at all and little or no symptoms.

The causes of spina bifida are not well understood. The defect usually occurs within the first month of pregnancy. Viruses, radiation, or other exposures may be a cause. Women who have one affected child have a greater chance of having another. This suggests genetic factors.

A test is available that can identify spina bifida during pregnancy. Fluid obtained from the womb can indicate defects by the fourteenth week of pregnancy. A sonogram during pregnancy can often detect or confirm a defect.

Research shows that increased folic acid in the diet will decrease the number of babies born with spina bifida. The US government now requires all flour, rice, pasta, and cornmeal to have folic acid added to these products. The amount required does not meet the daily minimum requirements to prevent spina bifida. All women of childbearing age should discuss with their healthcare provider the need to take extra folic acid.

Treatment consists of surgery to close the protruding sac. It also involves continual assessment of growth and development. Surgery will not reverse nerve deficits. Before surgery, one must handle the baby with care. One should hold and cuddle the infant to promote bonding, but avoid placing pressure on the sac. When holding him on a lap, one should position him on his abdomen.

Supportive measures may include:

• waist or leg braces, walkers, crutches, and other equipment
• diet and bowel training and
• bladder therapy or devices that help in bladder control

Parents of a child with spina bifida may require support in meeting his physical and emotional needs. Depending on physical and mental deficits, the child may need to attend a special school.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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