Spina Bifida

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Spina bifida is a type of birth defect that affects how the spine and spinal cord develop. We don’t know what causes spina bifida, but genetics may be a factor. Many studies have also shown a link between a low folate diet in the mother and an increased risk of the disease.

Spina bifida can begin to develop in a fetus before the mother even knows she's pregnant, so we test for neural tube defects — problems with the hollow structure from which the brain and spinal cord form — in the first trimester of pregnancy.

 There are three kinds of spina bifida:

  • Occulta — small defect in one or more backbones. This is the least severe form.
  • Meningocele — when membranes poke through an open part of the spine and can form a cyst
  • Myelomeningocele — in this most severe form of spina bifida, membranes poke through and contain nerve roots or spinal cord and can lead to:
    • Paralysis and incontinence of bowel and bladder 
    • Hydrocephalus—a build-up of fluids in the brain that increases pressure on the brain

Symptoms    

Most children with occulta spina bifida will never be diagnosed. This condition rarely causes any symptoms or complications. It may be discovered during a routine medical exam or following X-rays of the lower back.

The immediate symptoms of meningocele and myelomeningocele include:

  • Sac filled with fluid leading out from the baby's spine
  • Spinal cord and tissue may also protrude through the back

Infants and children with meningocele or myelomeningocele spina bifida may also experience long-term symptoms such as:

  • Bowel and bladder problems
  • Frequent urinary tract and other infections
  • Learning disabilities
  • Build up of fluid in the brain
  • Curvature of the spine
  • Inability to walk

Many children with myelomeningocele are wheelchair-bound. 

Diagnosis & Treatment at UVA

Prenatal Testing 

During the first trimester of your pregnancy, you can take a blood test to predict your baby’s risk for spina bifida. If the test predicts a high risk of neural tube defects, then we may perform two more tests:

  • Amniocentesis — we take a sample of the fluid surrounding the baby to measure for factors indicating spine problems
  • Ultrasound

A diagnosis before your baby is born can help you and your doctor make plans if your baby will need further treatment.

After Birth Testing

Meningocele and myelomeningocele are usually found through a physical exam. Your baby will need many tests to find out which bones and nerves are involved. Your baby may also have kidney damage. We closely monitor babies with these types of spina bifida.

Treatment    

Occulta spina bifida requires no treatment.

Meningocele spina bifida is treated with surgery to remove the cyst.

Treatment for myelomeningocele spina bifida is complicated. It may include surgery to place the nerves and spinal cord back in place, physical therapy for any physical problems, and supportive care for any other complications. 

Treatments for myelomeningocele may include:

  • Surgery
  • Physical therapy
  • Ongoing treatment

Preventing Spina Bifida

To help reduce the chance that your baby will be born with spina bifida, ask your doctor if the medications you take can increase the risk of having a baby with the disease. Taking folic acid supplements before conception and throughout pregnancy can reduce the risk for spina bifida.

A vitamin supplement may be the most reliable method of getting folate, but you can also get folate from these foods:

  • Leafy green vegetables
  • Orange juice
  • Beans
  • White flour products and cereals fortified with folate