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by Cynthia M. Johnson, MA
SB (SB) is a birth defect. It is a problem with how the spine and spinal cord form. SB can start to form in a fetus before the mother even knows she is pregnant. In some cases, structures that should be inside the spinal canal can slip out, such as:
There are three kinds of spina bifida:
The cause of SB isn’t known. There is a strong genetic factor for some with SB.
Studies have shown a link between a low folate diet in the mother and birth defects. In particular, low folate diets are linked to a higher risk of SB.
Risk Factors TOP
SB is more likely in females. Other things that raise the risk of SB are:
Occulta may not have any symptoms. Some with this type may never know they have SB. There may be a small tuft of hair or change in skin color over the low back.
The symptoms of meningocele and myelomeningocele are:
A blood test of the mother before birth can predict the risk of SB. If the test predicts a high risk of neural tube defects, then two more tests may be done:
A diagnosis before birth can help you and your doctor make plans. Surgery may be needed soon after birth.
After Birth Testing
After birth, meningocele and myelomeningocele can be seen. Many tests will be needed to find out which bones and nerves are involved. The kidneys may also be harmed. They will need to be watched closely.
Most children with occulta SB will never be diagnosed. It rarely causes any symptoms. It also has few problems. It may be found during a routine medical exam orx-rays of the lower back.
Occulta SB doesn’t need treatment.
Meningocele SB is treated with surgery. It is done to remove the cyst. This form of SB can be treated.
Treatment for myelomeningocele SB is complex. It may include:
During surgery, the nerves, membrane, and spinal cord are put back into place. It will be done within 24-48 hours after birth. In some cases, it may be done before birth.
Surgery is done as early as possible to prevent further nerve damage. It cannot reverse damage that has happened.
More serious forms of SB may require more surgeries throughout childhood.
Therapists will teach parents how to exercise the infant's legs and feet. Walkers, braces, and crutches will often be needed to let the baby move around.
Ongoing Treatment TOP
Complications of SB can be ongoing and extensive. It will be important for you to work with a team of doctors. You will need to get help for your child's physical needs and emotional support for you and your family.
To lower the chance that your baby will be born with SB:
March of Dimes
Spina Bifida Association of America
Sick Kids—The Hospital for Sick Children
Spina Bifida and Hydrocephalus Association of Canada
Aherens K, Yazdy MM, Mitchell AA, Werler MM. Folic acid intake and spina bifida in the era of dietary folic acid fortification. Epidemiology. 2011;22(5):731-737.
Shin M, Besser LM, Siffel C, et al. Prevalence of spina bifida among children and adolescents in 10 regions in the United States. Pediatrics. 2010;126(2):274-279.
Spina bifida. American Academy of Pediatrics Healthy Children website. Available at:
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Updated November 21, 2015. Accessed July 2, 2018.
Spina bifida. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115300/Spina-bifida. Updated December 15, 2017. Accessed July 2, 2018.
T Alegra, F Vairo, et al. Enzyme replacement therapy for Fabry disease: A systematic review and meta-analysis. Genet Mol Biol 2012; 35(4 supplemental):947-954.
Last reviewed June 2018 by Kari Kassir, MD
Last Updated: 7/2/2018
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