Spina bifida, which literally means “cleft spine,” is characterized by the incomplete
development of the brain, spinal cord, and/or meninges (the protective covering around
the brain and spinal cord). Types of Spina Bifida
There are four types of spina bifida:
Occulta is the mildest and most common form
in which one or more vertebrae are malformed. The name “occulta,” which means “hidden,”
indicates that the malformation, or opening in the spine, is covered by a layer of
skin. This form of spina bifida rarely causes disability or symptoms.
tube defects make up the second type of spina bifida. This form consists of a diverse
group of spinal defects in which the spinal cord is marked by a malformation of fat,
bone, or membranes. In some patients there are few or no symptoms; in others the
malformation causes incomplete paralysis with urinary and bowel dysfunction.
third type, meningocele, the meninges protrude from the spinal opening, and the malformation
may or may not be covered by a layer of skin. Some patients with meningocele may
have few or no symptoms while others may experience symptoms similar to closed neural
Myelomeningocele, the fourth form, is the most severe and occurs when
the spinal cord is exposed through the opening in the spine, resulting in partial
or complete paralysis of the parts of the body below the spinal opening. The paralysis
may be so severe that the affected individual is unable to walk and may have urinary
and bowel dysfunction.
Signs and Symptoms of Spina Bifida The symptoms of spina bifida
vary from person to person, depending on the type. Often, individuals with occulta
have no outward signs of the disorder. Closed neural tube defects are often recognized
early in life due to an abnormal tuft or clump of hair or a small dimple or birthmark
on the skin at the site of the spinal malformation.
Meningocele and myelomeningocele generally involve a fluid-filled sac—visible on
the back—protruding from the spinal cord. In meningocele, the sac may be covered
by a thin layer of skin, whereas in most cases of myelomeningocele, there is no layer
of skin covering the sac and a section of spinal cord tissue usually is exposed.
There is no cure for spina bifida. The nerve tissue that is damaged or lost cannot
be repaired or replaced, nor can function be restored to the damaged nerves. Treatment
depends on the type and severity of the disorder. Generally, children with the mild
form need no treatment, although some may require surgery as they grow.
The key priorities
for treating myelomeningocele are to prevent infection from developing through the
exposed nerves and tissue of the defect on the spine, and to protect the exposed
nerves and structures from additional trauma. Typically, a child born with spina
bifida will have surgery to close the defect and prevent infection or further trauma
within the first few days of life.