Spina bifida is a spine condition that doctors usually notice at birth. It is a neural tube defect that emerges early in a fetus’s development and can occur anywhere along the spine.
In spina bifida, the backbone that typically protects the spine does not form and close as it should. As a result, those with spina bifida often have spinal cord and nerve damage.
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This article looks at baby spine problems, including spina bifida. It also covers symptoms, diagnosis, and potential treatment options.
The spine consists of small bones called vertebrae stacked one on top of the other with discs in between. A healthy spine should have gentle curves from front to back to help absorb stress from movement, but it should run straight down the middle of the back.
Infants may have various spine problems that can twist or rotate their back. These include:
- scoliosis, an abnormal sideways spinal curve
- kyphosis, an abnormal forward bending of the spine
- lordosis, an excessive inward curve of the spine
- spina bifida
Spina bifida, meaning “split spine,” is the most common disabling congenital disorder. Doctors classify the condition as a type of neural tube defect (NTD) in which a developing embryo’s neural tube does not develop or close as expected. This leads to damage to the nerves and spinal cord.
These issues begin during the first 28 days of pregnancy and may happen before someone knows they are pregnant.
Experts sometimes refer to spina bifida as the “snowflake condition,” as no two cases are the same. The condition can range from mild to severe depending on the size of the opening and location.
There are three primary types of spina bifida:
- Myelomeningocele: Also called spina bifida cystica, this is the most common and severe type of spina bifida. In babies with this condition, some vertebrae do not develop as they should and do not enclose the spinal cord correctly. Therefore, some of the spinal cord, nerves, spinal fluid, and other tissues push through the spine, forming a sac that protrudes from the baby’s back. Due to the nerve involvement, an individual may experience moderate to severe disability.
- Meningocele: With this type of spina bifida, the baby has a sac protruding from the back. However, the sac does not contain parts of the spinal cord, and because there is less nerve involvement, the individual may experience only minor disabilities.
- Spina bifida occulta: This is the mildest form of spina bifida. An individual may not know they have this issue, as there is only a gap in the spine and no opening in the back. Babies with spina bifida occulta may have a birthmark, dimple, or patch of hair at the base of their spine.
Doctors do not know what causes spina bifida. However, it appears to run in families, which indicates that genetics contribute to the condition.
Taking folic acid while pregnant reduces the likelihood of having a baby with spina bifida. Therefore, people who may become pregnant should take daily doses of this B vitamin. The Centers for Disease Control and Prevention (CDC) recommend that females of reproductive age take
The symptoms of spina bifida depend on the severity of the condition and
Myelomeningocele symptoms include:
- open spine
- a skin-covered sac protruding from the back
- hydrocephalus
- learning disabilities
- physical disabilities
- bowel and bladder issues
- paralysis
- seizures
- curved spine
An individual with a meningocele may experience no symptoms aside from the sac protruding through their back.
With spina bifida occulta, individuals may be unaware they have the condition until late childhood or adulthood. It may cause no symptoms and usually does not cause disability.
Doctors can use three tests to detect spina bifida before birth:
- Blood test: Doctors can take a blood sample from a person during weeks 16–18 of pregnancy. A laboratory then measures the amount of alpha-fetoprotein (AFP) in the sample. AFP is a protein the unborn baby produces and passes to the mother. Around 80% of pregnant people have high levels of AFP if the fetus has spina bifida.
- Ultrasound: An ultrasound or sonogram is a form of imaging that captures pictures of the fetus in the uterus. Doctors can
frequently see signs of spina bifida, such as the open spine, using ultrasound. - Amniocentesis: This test involves taking a small fluid sample from the uterus with a thin needle. Doctors can use the sample to look at AFP levels, which may indicate the fetus has spina bifida.
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- Myelomeningocele: In open spina bifida, a surgeon can close the hole before the baby is born or in the days following the birth.
- Hydrocephalus: A surgeon can implant a tube to drain the fluid if a baby has hydrocephalus, or water on the brain. This tube or shunt helps relieve pressure on the brain and related symptoms.
- Tethered spinal cord: In this condition, the spinal cord attaches to the spinal canal and limits healthy movement. As the child grows, the spinal cord stretches abnormally. A surgeon can untether or separate the spinal cord from the surrounding tissue, which helps the individual regain their usual movement. Doctors estimate that up to 50% of children who undergo surgery for spina bifida issues shortly after birth later require surgery to untether their spinal cord.
- Catheterization: Individuals with open spina bifida may have nerve damage that prevents normal bladder function. A doctor may recommend that the child’s caregivers catheterize the bladder and allow it to empty fully. This involves inserting a small plastic tube called a catheter into the bladder several times a day. Children with spina bifida require regular assessment from a urologist, a doctor who specializes in the urinary tract.
Additionally, many individuals with spina bifida require assistive mobility devices, such as braces, crutches, or wheelchairs. Doctors may also recommend ongoing physiotherapy.
The outlook for an infant with spina bifida
However, with correct care and medical attention, most infants with spina bifida live well into their adult years.
Spina bifida is one of several infant spine problems that occur as a fetus develops in the uterus. There are three main types that vary in severity. The most serious is myelomeningocele, where a fluid-filled sac containing the spinal cord and other tissues protrudes through the infant’s back.
In meningocele, a sac is present but does not contain the spinal cord or nerves, and an individual may not experience severe symptoms. The mildest form of spina bifida is spina bifida occulta, where no sac protrudes through the back, but there is a gap in the spine. An individual with this form of spina bifida may be unaware they have the condition until adulthood.
Doctors have no cure for spina bifida, as the nerve damage is permanent. However, surgeries and other treatments can help people manage their disabilities and mobility problems.