Spina Bifida

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UT Southwestern Medical Center is a leader in the care of children and adults with spina bifida, a defect of the spine. Our compassionate specialists have the experience and resources to help manage even the most severe cases of this condition.

Specialized Expertise for Spina Bifida

Spina bifida is one of the most common birth defects. It occurs when the neural tube – the narrow sheath that forms the baby’s early brain and spine – doesn’t fully close during the first month of pregnancy. This can cause spinal cord and nerve damage.

At UT Southwestern, we have extensive expertise in the diagnosis and treatment of spina bifida, from prenatal to adult patients. UT Southwestern Pediatric Group’s Pediatric Spina Bifida and Neurogenic Bladder Center is the premier center in North Texas for spina bifida care, with the ability to perform spine-repairing surgery while a fetus is still in the womb. The Center includes a transition program and integration with adult providers for older spina bifida patients.

Our multidisciplinary team includes specialists in maternal-fetal medicine, pediatric neurology, pediatric urology, orthopaedic surgery, and physical medicine and rehabilitation.

Causes of Spina Bifida

Doctors don’t know exactly what causes spina bifida, but they believe a combination of certain genetic, nutritional, and environmental factors plays a role.

Factors that can increase a woman’s chances of having a baby with spina bifida include:

Folic acid deficiency
Diabetes
Seizure disorders that are treated with particular anticonvulsant medicines

Folic acid is a common B vitamin found in most multivitamins. To help prevent birth defects of the brain and spine, such as spina bifida, the Centers for Disease Control and Prevention (CDC) recommends that all women of reproductive age:

Take 400 micrograms (mcg) of folic acid every day
Eat foods with folate, such as eggs and leafy greens, from a varied diet

Symptoms of Spina Bifida

The symptoms of spina bifida depend on the extent of the malformation. Three types of spina bifida are most common:

Myelomeningocele

This is the most serious type of spina bifida. It’s characterized by a sac of fluid that comes through an opening in the back, and that sac contains a portion of the undeveloped spinal cord.

Myelomeningocele can cause moderate to severe disabilities, ranging from bowel and bladder problems to paralysis of the legs.

Meningocele

This rare type of spina bifida is characterized by a sac of fluid that protrudes through an opening in the back. It contains the layers of membranes covering the spinal cord (meninges) but not the spinal cord itself.

Meningocele can cause minor disabilities.

Spina bifida occulta

Often called hidden spina bifida, this is the mildest type of the defect. The skin covers the deformity of the spinal bone, and there is often no spinal dysfunction. People who have spina bifida occulta may not be aware they have it.

Diagnosing Spina Bifida

Spina bifida is usually diagnosed during pregnancy, but it can also be discovered after the baby is born.

Spina bifida occulta might never be diagnosed if there are no symptoms or complications.

Prenatal spina bifida diagnosis

UT Southwestern specialists perform the most advanced screening tests to check for birth defects. Because spina bifida has a hereditary factor, we’ll first find out if that condition runs in the family.

Prenatal tests we might use to detect spina bifida include:

Alpha-fetoprotein (AFP) test: This blood test, given in the second trimester of pregnancy, measures the level of a protein produced in the baby’s liver. A high level of AFP may indicate spina bifida.
Ultrasound: We’ll use high-frequency sound waves to produce a picture of the baby and see if there is a spinal cord defect. Most cases of spina bifida are detected this way.
Amniocentesis: This procedure involves the doctor taking a small sample of the amniotic fluid surrounding the baby in the womb to check the AFP levels. We may recommend this test if the patient has high levels of AFP that couldn't be explained by an ultrasound.

Postnatal spina bifida diagnosis

Spina bifida might not be diagnosed until after birth if:

The ultrasound didn’t produce clear images of the part of the spine that was affected
The mother didn’t receive proper prenatal care

We typically use imaging tests to diagnose spina bifida after birth, including X-rays, magnetic resonance imaging (MRI), and computed tomography (CT). These technologies give us detailed pictures of the baby’s spine and the bones of the back.

Spina Bifida Treatment

Until recently, spina bifida was mostly known as a pediatric disability. Because of advancements in medical, surgical, and rehabilitative fields, an increasing number of adults are living with spina bifida today.

Treatment for spina bifida depends on the severity of the condition. It may include:

Surgery

We may perform surgery on babies who develop excessive fluid in the brain (hydrocephalus). Our doctors use a small, hollow tube called a shunt, which remains in place throughout the person’s life, to drain the fluid.

Some children will need subsequent surgeries to manage feet, hip, spine, and urinary tract problems.

Other treatments

Spina bifida can cause complications that require additional treatment methods, including:

Walking and mobility aids, such as braces, crutches, or a wheelchair
Bladder catheterizations and bowel management regimens to help with bladder and bowel problems
Physical activity to help with movement