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Spina bifida is a birth defect that occurs when the spine and spinal cord don’t form properly. It falls under the broader category of neural tube defects. The neural tube is the embryonic structure that eventually develops into the baby’s brain and spinal cord and the tissues that enclose them.
Normally, the neural tube forms early in pregnancy, and it closes by the 28th day after conception. In babies with spina bifida, a portion of the neural tube fails to develop or close properly, causing defects in the spinal cord and in the bones of the spine.
Spina bifida can range from mild to severe, depending on the type of defect, size, location and complications. When early treatment for spina bifida is necessary, it’s done surgically, although such treatment doesn’t always completely resolve the problem.
Spina bifida can occur in different forms: spina bifida occulta, meningocele (muh-NING-go-seel) or myelomeningocele (my-uh-lo-muh-NING-go-seel). The severity of spina bifida depends on the type, size, location and complications.
Spina bifida occulta
“Occulta” means hidden. The mildest form, spina bifida occulta results in a small separation or gap in one or more of the bones of the spine (vertebrae). Many people who have spina bifida occulta don’t even know it, unless the condition is discovered during an imaging test done for unrelated reasons.
In a form of spina bifida called meningocele, the protective membranes around the spinal cord (meninges) push out through the opening in the vertebrae, forming a sac filled with fluid. But this sac doesn’t include the spinal cord, so nerve damage is less likely, though later complications are possible.
Also known as open spina bifida, myelomeningocele is the most severe form. The spinal canal is open along several vertebrae in the lower or middle back. The membranes and spinal nerves push through this opening at birth, forming a sac on the baby’s back, typically exposing tissues and nerves. This makes the baby prone to life-threatening infections.
Signs and symptoms of spina bifida vary by type and severity. Symptoms can also differ for each person.
- Spina bifida occulta: Because the spinal nerves usually aren’t involved, typically there are no signs or symptoms. But visible indications can sometimes be seen on the newborn’s skin above the spinal defect, including an abnormal tuft of hair, or a small dimple or birthmark.
- Meningocele: The membranes around the spinal cord push out through an opening in the vertebrae, forming a sac filled with fluid, but this sac doesn’t include the spinal cord.
- Myelomeningocele – In this severe form of spina bifida:
- The spinal canal remains open along several vertebrae in the lower or middle back.
- Both the membranes and the spinal cord or nerves protrude at birth, forming a sac.
- Tissues and nerves usually are exposed, though sometimes skin covers the sac.