Spina bifida is a condition where the spine does not develop properly, leaving a gap in the spine.
During the first month of life, an embryo (developing baby) grows a structure called the neural tube that will eventually form the spine and nervous system. When something goes wrong with this process, the result is called a "neural tube defect". Spina bifida is one type of neural tube defect.
The spine consists of the spinal column, which is a solid structure made up of bones (called vertebral bodies) separated by discs of fibrous tissue. Behind this is an enclosed space called the spinal canal, which contains the spinal cord. The spinal cord connects all the nerves in the body to the brain. The canal is surrounded by arches of bone attached to the backs of the vertebral bodies.
In cases of spina bifida, something goes wrong and the arches of bone do not fully close. Sometimes there is only a gap in the bony arch, but at other times the spinal cord is also involved and does not form properly either. The skin over the arch can also either be intact or have a gap as well.
The exact cause is unknown, but several things can increase your risk of having a baby with the condition, the most significant being a lack of folic acid before and in the early stages of pregnancy.
There are several different types of spina bifida.
Myelomeningocele is one of the most serious types of spina bifida. The opening in the spinal arches allows the spinal cord and the protective membranes surrounding it (the meninges) to push out and create a sac in the baby’s back.
It can be associated with significant damage to the spinal cord and can leave the nervous system vulnerable to life-threatening infections.
In meningocele, only the meninges push out of the opening in the spine.
This can usually be corrected with surgery and often no further treatment is required. The spinal cord and nervous system are not normally damaged, although some people with the condition may have symptoms such as bladder and bowel problems.
Spina bifida occulta is the most common and mildest type of spina bifida. The opening in the spine is very small and covered with skin. This means that the spinal cord and meninges can't push out and there is no obvious bulge in the back.
It doesn't usually cause any symptoms and most people are unaware they have it, although some people may have bladder and bowel problems, or weakness and reduced sensation in their legs.
These pages focus on myelomeningocele and this is the type referred to whenever the term spina bifida is used. You can read more about the other types of spina bifida on the Shine website.
In most cases of myelomeningocele, surgery can be carried out to close the opening in the spine. However, damage to the nervous system will usually already have taken place.
The damage to the spinal cord can lead to problems such as:
Many babies will have or will develop hydrocephalus (excess fluid on the brain), which can further damage the brain. Most people with spina bifida will have a normal intelligence, but learning difficulties are common, especially with hydrocephalus.
A number of different treatments can be used to treat symptoms or conditions associated with spina bifida.
With appropriate treatment and support, it's likely that children with spina bifida will survive well into adulthood. It can be a challenging condition to live with, but many adults with spina bifida are able to lead independent and fulfilling lives.
If you or your child has spina bifida, your clinical team will pass information about you/your child on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS).
This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time.