What Is Spina Bifida? Treatment Methods Explained

Spina bifida, also known as a neural tube defect, is a congenital condition characterized by a split or open spine.

What Is Spina Bifida?

The spinal cord transmits signals from the brain to the muscles, allowing the body to function properly. Spina bifida is a developmental disorder in which the bones of the spine do not close completely during fetal development. This condition arises in the first month of pregnancy and does not develop later in life.

Spina bifida can impair the spinal cord’s ability to function correctly. In some cases, the spinal cord and the overlying skin do not close properly, and the spinal cord may even protrude outside the body. This can disrupt communication between the brain and nerves, potentially leading to varying degrees of paralysis, loss of sensation, or mobility limitations.

The higher the opening on the spine, the more severe the effects. Some individuals with spina bifida can walk, while others may be unable to control bowel or bladder functions.

A Closer Look at Spina Bifida

Spina bifida is a type of neural tube defect—a group of congenital anomalies affecting the brain or spinal cord. In a healthy pregnancy, the spine closes along the midline by around the 29th day after conception. In spina bifida, this closure is incomplete or absent.

It is one of the most common congenital disorders, affecting 1 to 2 out of every 1,000 births. The spinal cord—an essential structure responsible for muscle movement and sensory transmission—cannot function properly in spina bifida.

In severe cases, the baby may be born with an opening in the back, leaving nerves and tissues exposed, which increases the risk of infection and complications. The severity of impairment depends on the location of the spinal defect. Defects closer to the head typically cause greater dysfunction. However, spina bifida most commonly affects the lower back.

Types of Spina Bifida

Spina bifida is classified into two major types with several subtypes. The most common forms include:

1. Spina Bifida Occulta (SBO)

This is the mildest and most common form, often called “hidden spina bifida.” Many people are unaware they have it until it is detected on an X-ray performed for another reason. A small portion of the spine is affected, and the skin usually covers the defect. Signs may include a birthmark, dimple, or patch of hair on the lower back.

SBO usually doesn’t cause physical limitations and doesn’t require surgery. However, in rare cases, it may lead to a tethered cord, a condition in which the spinal cord becomes abnormally stretched, causing weakness in the legs.

2. Spina Bifida Cystica

This is the cystic form of spina bifida and includes two subtypes:

• Meningocele: The meninges (protective layers around the spinal cord) protrude through the open spinal bones, forming a fluid-filled sac. The spinal cord is not involved in this sac, so nerve damage is minimal. However, complications can still develop later in life.
• Myelomeningocele: The most severe and common form. Here, the spinal canal remains open along several vertebrae, and the sac contains both meninges and spinal nerves. This exposed tissue greatly increases the risk of infections and severe disability.

What Causes Spina Bifida?

While the exact cause of spina bifida is unknown, both genetic and environmental factors are believed to contribute. Risk factors include:

• Folate deficiency: Inadequate levels of folic acid before and during early pregnancy increase the risk.
• Family history: A history of neural tube defects in the family increases the likelihood.
• Certain medications: Drugs like valproic acid (used for epilepsy) can interfere with folate levels and increase risk.
• Uncontrolled diabetes and obesity during pregnancy also raise the likelihood of neural tube defects.

However, the presence of these factors does not guarantee that a baby will be born with spina bifida.

Can Spina Bifida Be Prevented?

Although it may not be completely preventable, the risk of spina bifida can be significantly reduced by taking folic acid supplements before and during pregnancy. Healthcare professionals recommend starting folic acid (400 mcg daily) at least one month before conception. If pregnancy is unplanned, folic acid should be taken as soon as pregnancy is confirmed.

Diagnosis and Treatment of Spina Bifida

Spina bifida can be detected during pregnancy through routine ultrasound or amniocentesis. However, it is often identified just before or during birth.

Treatment depends on the type and severity of the condition:

• Fetal Surgery: In some cases, surgery can be performed in the womb before the 26th week of pregnancy to reduce the risk of future disability.
• Postnatal Surgery: Corrective surgery shortly after birth can help protect exposed nerves and prevent further complications.
• Physical Therapy: Essential for improving mobility and strengthening leg muscles.
• Ongoing Care: Some patients may need orthopedic support, bladder or bowel management, and regular follow-ups to manage symptoms and improve quality of life.