Spina bifida

What is it?

Spina bifida is a condition which occurs when one or more of the bones in a baby’s spine fails to form properly very early on in development in the womb. This leaves a gap in the spine, so that part of the spinal cord, which lies inside the spine, is left exposed and unprotected. In some cases, the cord may be damaged too.

There are different types of spina bifida. The mildest kind affects as many as 5-10 per cent of people. In these cases there are no outward signs, apart from sometimes a dimple or mole or patch of hair on the back, and no disability or problems. In some cases there may be weakness and loss of feeling in the legs as well as difficulties in controlling the bladder.

In the more severe form of spina bifida, the baby is born with a growth like a large blister on his back. If the growth doesn’t have any of the spinal cord in it, it may well cause little or no disability. More commonly, though, it does contain part of the spinal cord, which is either damaged or not properly developed. This causes severe disabilities, including paralysis and loss of sensation below the damaged area, and permanent lack of bladder and bowel control. The baby may also have a deformed spine and/or limbs. Most babies with this form of spina bifida also have hydrocephalus.

What causes it?

Spina bifida is caused when the structure that develops into the brain and the spinal cord fails to form properly in the first few weeks after conception. No one really knows why this happens, but it seems likely to be due to a complicated interaction of genetic and other factors.

It can be diagnosed antenatally by ultrasound or by amniocentesis.

Folic acid helps prevent spina bifida from developing. The Department of Health in the UK recommends that all women planning a baby, and women in early pregnancy, should take a folic acid supplement and eat a diet high in folic acid. More details are available in our healthy eating during pregnancy section.

Looking after a child with spina bifida

The type of care that a child with spina bifida needs varies according to which form of it he has. Most children with the ‘hidden’ type will need no special care - in fact, they may never even know that they have it.

A baby with the less severe form of defect on the back will need to have the growth operated on soon after birth, but isn’t likely to have any serious long-term problems. A baby with the most severe form of defect, who will also need to be operated on, will have a range of problems and will probably need a lot of special care. The kind of care he will need depends on how severe the problems are.

You can find out more about spina bifida on the Association for Spina Bifida and Hydrocephalus site, which has links to other sites.