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Spina Bifida Definition

Spina bifida is a birth defect that occurs when the spine and spinal cord don't form properly. It falls under the broader category of neural tube defects. The neural tube is the embryonic structure that eventually develops into the baby's brain and spinal cord and the tissues that enclose them.

Normally, the neural tube forms early in pregnancy, and it closes by the 28th day after conception. In babies with spina bifida, a portion of the neural tube fails to develop or close properly, causing defects in the spinal cord and in the bones of the spine.

Spina bifida can range from mild to severe, depending on the type of defect, size, location and complications. When early treatment for spina bifida is necessary, it's done surgically, although such treatment doesn't always completely resolve the problem.

Types

Spina bifida (myelomeningocele)

Spina bifida can occur in different forms: spina bifida occulta, meningocele (muh-NING-go-seel) or myelomeningocele (my-uh-lo-muh-NING-go-seel). The severity of spina bifida depends on the type, size, location and complications.

Spina bifida occulta

"Occulta" means hidden. The mildest form, spina bifida occulta results in a small separation or gap in one or more of the bones of the spine (vertebrae). Many people who have spina bifida occulta don't even know it, unless the condition is discovered during an imaging test done for unrelated reasons.

Meningocele

In a form of spina bifida called meningocele, the protective membranes around the spinal cord (meninges) push out through the opening in the vertebrae, forming a sac filled with fluid. But this sac doesn't include the spinal cord, so nerve damage is less likely, though later complications are possible.

Myelomeningocele

Also known as open spina bifida, myelomeningocele is the most severe form. The spinal canal is open along several vertebrae in the lower or middle back. The membranes and spinal nerves push through this opening at birth, forming a sac on the baby's back, typically exposing tissues and nerves. This makes the baby prone to life-threatening infections.

Symptoms

Signs and symptoms of spina bifida vary by type and severity. Symptoms can also differ for each person.

Spina bifida occulta. Because the spinal nerves usually aren't involved, typically there are no signs or symptoms. But visible indications can sometimes be seen on the newborn's skin above the spinal defect, including an abnormal tuft of hair, or a small dimple or birthmark.Meningocele. The membranes around the spinal cord push out through an opening in the vertebrae, forming a sac filled with fluid, but this sac doesn't include the spinal cord.Myelomeningocele. In this severe form of spina bifida:The spinal canal remains open along several vertebrae in the lower or middle back.Both the membranes and the spinal cord or nerves protrude at birth, forming a sac.Tissues and nerves usually are exposed, though sometimes skin covers the sac.

When to see a doctor

Typically, meningocele and myelomeningocele are diagnosed before or right after birth, when medical care is available. These children should be followed by a specialized team of doctors throughout their lives and families should be educated on the different complications to watch for.

Children with spina bifida occulta typically don't have any symptoms or complications, so usually only routine pediatric care is needed.

Doctors aren't certain what causes spina bifida. As with many other problems, it appears to result from a combination of genetic and environmental risk factors, such as a family history of neural tube defects and folate deficiency.

Risk factors

Spina bifida is more common among whites and Hispanics, and females are affected more often than males. Although doctors and researchers don't know for sure why spina bifida occurs, they have identified some risk factors:

Folate deficiency. Folate (vitamin B-9) is important to the healthy development of a baby. Folate is the natural form of vitamin B-9. The synthetic form, found in supplements and fortified foods, is called folic acid. A folate deficiency increases the risk of spina bifida and other neural tube defects.

Family history of neural tube defects. Couples who've had one child with a neural tube defect have a slightly higher chance of having another baby with the same defect. That risk increases if two previous children have been affected by the condition. In addition, a woman who was born with a neural tube defect has a greater chance of giving birth to a child with spina bifida. However, most babies with spina bifida are born to parents with no known family history of the condition.

Some medications. For example, anti-seizure medications, such as valproic acid (Depakene), seem to cause neural tube defects when taken during pregnancy, possibly because they interfere with the body's ability to use folate and folic acid.

Diabetes. Women with diabetes who don't control their blood sugar well have a higher risk of having a baby with spina bifida.

Obesity. Pre-pregnancy obesity is associated with an increased risk of neural tube birth defects, including spina bifida.

Increased body temperature. Some evidence suggests that increased body temperature (hyperthermia) in the early weeks of pregnancy may increase the risk of spina bifida. Elevating your core body temperature, due to fever or the use of saunas or hot tubs, has been associated with a possible slight increased risk of spina bifida.

Source: 
https://www.mayoclinic.org/diseases-conditions/spina-bifida/symptoms-causes/syc-20377860