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Symptoms
By Mayo Clinic staff
Spina bifida occurs in three forms, each varying in severity:
Spina bifida occulta
This mildest form results in a small separation or gap in one or more of the bones (vertebrae) of the spine. Because the spinal nerves usually aren't involved, most children with this form of spina bifida have no signs or symptoms and experience no neurological problems. Visible indications of spina bifida occulta can sometimes be seen on the newborn's skin above the spinal defect, including:
- An abnormal tuft of hair
- A collection of fat
- A small dimple or a birthmark
- Skin discoloration
Many people who have spina bifida occulta don't even know it, unless the condition is discovered during an X-ray or other imaging test done for unrelated reasons.
Meningocele
In this rare form, the protective membranes around the spinal cord (meninges) push out through the opening in the vertebrae. Because the spinal cord develops normally, these membranes can be removed by surgery with little or no damage to nerve pathways.
Myelomeningocele
Also known as open spina bifida, myelomeningocele is the most severe form — and the form people usually mean when they use the term "spina bifida."
In myelomeningocele, the baby's spinal canal remains open along several vertebrae in the lower or middle back. Because of this opening, both the membranes and the spinal cord protrude at birth, forming a sac on the baby's back. In some cases, skin covers the sac. Usually, however, tissues and nerves are exposed, making the baby prone to life-threatening infections.
Neurological impairment is common, including:
- Muscle weakness, sometimes involving paralysis
- Bowel and bladder problems
- Seizures, especially if the child requires a shunt
- Orthopedic problems — such as deformed feet, uneven hips and a curved spine (scoliosis)
- Spina bifida fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/spina_bifida/detail_spina_bifida.htm. Accessed June 28, 2011.
- Lightner DD. Spina Bifida. In: Ferri FF. Ferri's Clinical Advisor 2012: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05611-3..00028-8--sc29020&isbn=978-0-323-05611-3&sid=1180550958&uniqId=266655520-3#4-u1.0-B978-0-323-05611-3..00028-8--sc29020
- Spina bifida. March of Dimes. http://www.marchofdimes.com/pnhec/4439_1224.asp. Accessed June 27, 2011.
- Sandler AD. Children with spina bifida: Key clinical issues. Pediatric Clinics of North America. 2010;57:879.
- Folic acid: Questions and Answers. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/folicacid/faqs.html. Accessed June 29, 2011.
- Spina bifida. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/spinabifida/facts.html. Accessed June 30, 2011.
- Hochberg L. Prenatal screening and diagnosis of neural tube defects. http://www.uptodate.com/home/index.html. Accessed June 30, 2011.
- Routine tests in pregnancy. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp133.cfm. Accessed June 30, 2011.
- Adzick NS, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. New England Journal of Medicine. 2011;364:993.
- Surgery on fetus reduces complications of spina bifida. National Institutes of Health. http://www.nichd.nih.gov/news/releases/020911-MOMS.cfm?renderforprint=1. Accessed June 30, 2011.
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