Spina bifida

There for the physical and mental development of your child

Spina bifida means ‘open spine’. It is a malformation of the spine and often of the spinal cord that develops during pregnancy. On average, one in 1,000 newborns is affected, and girls are generally affected more often than boys. Patients need regular and individual medical treatment throughout their lives.

Spina bifida is a disease that can only be approached in an interdisciplinary manner. At Schoen Clinic, paediatric orthopaedists, spinal surgeons, neurosurgeons, urologists and neuropaediatricians work closely together to offer your child holistic care. Thanks to early detection and operations in infancy, it is possible that many children with spina bifida develop considerably better physically and mentally and long-term damage can be minimised.

Causes & symptoms

What does spina bifida mean?

Spina bifida is composed of the two Latin terms spina (“spine”, “thorn”) and bifidus (“split into two parts”). In English, the name means “open spine” or “split spine”.

A distinction is made between two types:
  • Spina bifida occulta
    In this form of spina bifida, there is a split vertebral arch without the involvement of the spinal cord membranes and the spinal cord. It is thus not visible from the outside. Since spina bifida occulta is usually asymptomatic, no treatment is necessary.
  • Spina bifida aperta
    It describes the open or visible form of spina bifida. The symptoms depend on which parts of the spinal cord are affected and where in the spinal column the gap is located.

Spina bifida – causes of this disease

The spinal column forms very early during the development of the embryo in the womb. The brain, spinal cord and surrounding tissue develop from a common attachment, the neural tube. It is normally fully formed between the 22nd and 28th day. In very rare cases, however, it tears or does not close completely. Then one or more vertebral arches remain open, the spinal cord membranes can protrude and also lie open.

Why this defect of the spinal column occurs is still unknown. Genetic factors as well as certain external influences can play a role. A lack of folic acid during pregnancy and the intake of certain medications to treat epilepsy increase the risk.

How you can prevent spina bifida

Folic acid is a B vitamin that is used for blood formation and plays a major role in all cell division and growth processes. However, even with a healthy and balanced diet, the need for folic acid in the unborn life cannot be met. Women who wish to have children should therefore inform their gynaecologist about taking folic acid.

Important folic acid suppliers include leafy vegetables such as spinach or lettuce, as well as wholemeal flour and beef liver. Tomatoes, potatoes and some cabbage and fruits, such as white cabbage and oranges, also contain plenty of folic acid.
Fruit and vegetables should be eaten fresh as long heating or storage destroys the vitamins they contain.

Spina bifida – symptoms: frequent complaints

The follow-up complications of spina bifida already start in early childhood, but may also only become noticeable in adulthood.

Problems include muscle weakness in the legs and paralysis of the legs, bladder and intestines. Hydrocephalus (water on the brain) is also possible. There are usually considerable problems concerning the musculoskeletal system. Severe scoliosis, joint contractures (especially of the lower extremities) and serious foot malpositions can occur. Hip dysplasia and dislocations of the hips are also frequently observed. Overall, patients’ mobility and independence can be considerably restricted by these problems.

Diagnostics

How we diagnose spina bifida

Today, spina bifida can already be diagnosed during pregnancy by means of regular ultrasound examinations. There is also the possibility of gaining an indication of spina bifida in the newborn by means of a blood test. In most cases, the visual findings after the birth are sufficient to diagnose the disease.
The interdisciplinary cooperation of paediatric orthopaedics, spinal surgery, neurosurgery and neuropaediatrics enables us to provide your child with holistic care. Possible neuropaediatric, neurosurgical, urological or orthopaedic problems can thus be detected and treated at an early stage.