Spina bifida

Spina bifida is a fault in the development of the spine and spinal cord which leaves a gap in the spine.

The spinal cord connects all parts of the body to the brain.

What causes spina bifida?

During the first month of life, an embryo (developing baby) grows a structure called the neural tube that will eventually form the spine and nervous system.

In cases of spina bifida, something goes wrong and the spinal column (the bone that surrounds and protects the nerves) does not fully close. Spina bifida is also known as split spine.

The exact causes are unknown, but several risk factors have been identified, the most significant being a lack of folic acid before and at the very start of pregnancy.

Read more about the causes of spina bifida and preventing spina bifida

Myelomeningocele

There are a number of different types of spina bifida, the most serious being myelomeningocele (affecting one pregnancy in every 1,000 in Britain).

These pages focus on myelomeningocele and this is the type of spina bifida referred to whenever the term spina bifida is used.

In myelomeningocele, the spinal column remains open along the bones making up the spine. The membranes and spinal cord push out to create a sac in the baby’s back. This sometimes leaves the nervous system vulnerable to infections that may be fatal.

In most cases of myelomeningocele, surgery can be carried out to close the defect. However, damage to the nervous system will usually already have taken place, resulting in a range of symptoms, including:

partial or total paralysis of the lower limbs
bowel incontinence and urinary incontinence
loss of skin sensation

Read more about the symptoms of spina bifida.

Most babies with myelomeningocele will also develop hydrocephalus, which is excess cerebrospinal fluid (CSF) surrounding the brain.

Hydrocephalus needs to be treated urgently with surgery as the pressure on the brain can cause brain damage.

Treating spina bifida

A number of different treatments can be used to treat symptoms or conditions associated with spina bifida.

These can include:

surgery on the spine – at birth to repair the spine, and corrective surgery later in life if further problems develop
surgery to treat hydrocephalus – for example, placing a shunt
therapies to help improve day to day life and boost independence – such as physiotherapy and occupational therapy
assistive technology – such as a manual or electric wheelchair or computer software to help with schoolwork and writing
treatments for bowel and urinary problems

It is likely that children with spina bifida will survive well into adulthood. It can be a challenging condition to live with, but many adults with spina bifida are able to lead independent and fulfilling lives.