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Spina Bifida

Part of the spine is open at birth


Updated June 14, 2014

Woman with Spina Bifida in wheelchair studying difficulty of accessing stairway
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Spina bifida occurs when the fetus is growing in the womb and its spine doesn't form correctly (a neural tube defect). Some of the vertebrae (bones in the spine) don't close to make their normal ring shapes around the spinal cord. The opening that results causes one of three types of spina bifida:
  • Spina bifida occulta: a tiny opening, usually causes mild or no symptoms
  • Spina bifida cystica - meningocele: a big enough opening so that some of the membrane surrounding the spinal cord sticks out through the opening
  • Spina bifida cystica - myelomeningocele: the most serious kind, in which some of the spinal cord itself sticks out through the opening in the spine.
What type of symptoms the person has depends on where along the spine the opening occurred, since that is where the spinal cord was injured. How severe the symptoms will be depends on which type of spina bifida has occurred. Children born with spina bifida may have other nervous system disorders such as hydrocephalus or Chiari malformation.

Who gets it?
In the U.S., spina bifida occurs more frequently among Hispanics and whites of European extraction, and less commonly among Asians and African-Americans. 95% of babies born with spina bifida have no family history of it. However, if a mother has a child with spina bifida, the risk of it happening again in a subsequent pregnancy is greatly increased.

Folic acid deficiency
Folic acid deficiency in the mother has been linked to the development of spina bifida in the baby. To help reduce the chance of spina bifida happening, the FDA mandated that all enriched cereal grain products be fortified with folic acid beginning in 1998. A study published in 2002 found that in the United States, there were 24% fewer cases of spina bifida between 1996-2001 compared to the years before. However, there are issues about adding folic acid to food.

A screening blood test, called an alphafetoprotein test (AFP), is done using the pregnant mother's blood when she is about 15-17 weeks into the pregnancy. If the results are abnormal, a detailed (Level II) ultrasound is done which can show the presence of spina bifida. An amniocentesis (sampling of the amniotic fluid in the womb) may be done to recheck the AFP level or do other tests.

There is no complete cure for spina bifida. The opening in the spine can be closed surgically either before or after birth, and this will reduce its effects on the body.

Since spina bifida causes injury to the spinal cord, treatment consists of managing the symptoms that the person has, such as difficulty standing, walking, or urinating. Some people will be able to walk with crutches or leg braces; others may need a wheelchair to get around. Children and adults with myelomeningocele will have the most medical complications and need the most medical care.

Life expectancy
The outlook for children with spina bifida has changed dramatically over the years. A study published in 2001 found that with appropriate medical care, at least 75% of children born with the most severe form of spina bifida (myelomeningocele) will most likely live until their early adult years. The study's authors point out that providing supportive care for these adults is challenging.


Bowman, R. M., D.G. McLone, J.A. Grant, T. Tomita, & J.A. Ito. "Spina bifida outcome: A 25-year prospective." Pediatr Neurosurg 34(2001): 114-120.

Mathews, T. J., M.A. Honein, & J.D. Erickson. "Spina bifida and anencephaly prevalence--United States." MMWR Recomm Rep 51(2002): 9-11.

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