Definition

Spina bifida (SB) is a neural tube defect (a disorder involving incomplete development of the brain, spinal cord, and/or their protective coverings) caused by the failure of the fetus's spine to close properly during the first month of pregnancy. Infants born with SB sometimes have an open lesion on their spine where significant damage to the nerves and spinal cord has occurred. Although the spinal opening can be surgically repaired shortly after birth, the nerve damage is permanent, resulting in varying degrees of paralysis of the lower limbs. Even when there is no lesion present there may be improperly formed or missing vertebrae and accompanying nerve damage.

In addition to physical and mobility difficulties, most individuals have some form of learning disability. The three most common types of SB are: myelomeningocele, the severest form, in which the spinal cord and its protective covering (the meninges) protrude from an opening in the spine; meningocele in which the spinal cord develops normally but the meninges protrude from a spinal opening; and occulta, the mildest form, in which one or more vertebrae are malformed and covered by a layer of skin.

SB may also cause bowel and bladder complications, and many children with SB have hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain).
 

The severity of Spina Bifida depends greatly on where the baby has developed Spina Bifida.

A baby born with a soft cyst on the back, it is called a "meningocele". This is usually located on the neck or the bottom of the spine, but it can occur at any point. The main dangering is that the skin covering might be very thin, and may become damaged and liable to infection. Early surgery on these are usually very successful.

Other types of Spina Bifida are more serious.

If part of the backbone, nerves and spinal cord are exposed at the bottom of the cyst, these will often burst even before birth. The severity of the handicap is depending on the part of the back that is affected. If the neck is affected, the nerves for breathing are usually affected and the baby will die shortly after birth. If the very bottom of the spine is involved, the few nerves going to the feet may be abnormal, and the baby may be born with nothing more serious than Club Feet. Club feet is where the bones in the ankle are in the wrong position, causing the ankle to twist. This can be corrected by either physiotherapy (which the mother can learn), or can be corrected by surgery.

If the middle of the back is involved, the results are usually far more serious. Generally, the greater the opening in the back, the worse the outlook. All of the babies will have at least some kind of derformity or weakness in the legs, which will result in him/her having to wear braces or being wheelchair-bound. A severely affected child may develop curvature of the spine at puberty, which can be corrected by major surgery. Hydrocephalus (water on the brain), often accompanies this kind of Spina Bifida, and surgery is very successful. For various reasons, some of these children may be mentally retarded to certain degrees.

Hydrocephalus and head  enlargement in an infant

The last type is a fatty lump that can form at the base of the spine. This is known as Spina Bifida Occulta, and is small and marked only by a dimple, or a tuft of hair. The danger of this is it may be ignored, for the baby might still be able to move its legs. Many deteriorate as they get older. An operation may be nescessary to free the trapped nerves, but this is not always successful.

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