Spina Bifida (Pediatric)

What is spina bifida?

Spina bifida literally means “split spine” and is the most common permanently disabling birth defect in the United States.

The neural tube is the embryonic structure that eventually develops into the baby’s brain and spinal cord and their surrounding tissues. Normally, the neural tube forms early in the pregnancy and closes 28 days after conception. Spina bifida arises when the neural tube fails to close completely, resulting in defects in the spinal cord and bones of the spine.

What causes spina bifida?

Spina bifida has many causes. Genetic, nutritional, and environmental factors each play a role. Research studies show insufficient intake of folic acid in the mother’s diet may also contribute.

What are the types of spina bifida?

There are two main types of spina bifida:

• Spinia bifida occulta is a defect limited to the vertebrae or bony part of the spinal column. "Occulta" means “hidden” and many people have this problem without knowing it. This type of spina bifida causes no neurological problems and is generally only found on an X-ray taken for another condition.
• Spina bifida myelomenigocele is the most severe type. A portion of the spinal cord and nerves protrude through the open part of the spine, causing nerve damage and other disabilities.

Though severe defects are surgically repaired early in life, children may suffer from complications such as paralysis, deficits in sensation, joint and bone deformities, scoliosis (curvature of the spine), respiratory problems, skin breakdown, and difficulties with bowel function and urination.

Children with spina bifida also have higher rates of obesity and metabolic problems associated with higher weight and lower energy expenditure.

What is the treatment for spina bifida?

Therapies to optimize mobility and physical function are crucial to preserve a healthy cardiovascular system.

Working alongside physical and occupational therapists, our rehabilitation specialists can prevent joint contracture while improving children's quality of life and their ability to function. Equipment such as wheelchairs and adaptive tools help with mobility and self-care.

We treat children's bowel and bladder issues with tailored regimens and pharmacotherapies. Regimens range from timed voids to clean, intermittent catheterization. We watch for complications associated with bladder retention and guide surveillance imaging to prevent kidney damage. Our physiatrists also team with urological specialists and refer children with urological problems to urologic surgeons, as necessary.

Children with spina bifida need to be monitored for abnormal bone alignment and formation. We help to manage this issue with braces or serial casting. Our physiatrists can coordinate surgical referrals to address these problems.

We also work with families to obtain services that help their children reintegrate into the community and transition to adulthood.