Spina Bifida

The complications associated with spina bifida vary in severity according to the type of spina bifida a person is diagnosed with. The size and location of the spinal defect determine which part of the body is affected and to what degree.

• Orthopedic complications. Orthopedic problems are common for most children with spina bifida. Club foot, dislocated hips, and curvature of the spine (scoliosis), in addition to contractures of the knee, hip, or ankle, all affect a child’s ability to walk.
• Leg and core muscle weakness. This generally happens with neural tube defects and myelomeningocele. People experience leg weakness and loss of sensation in the groin, feet, or legs. Sometimes the sensation is located on one side of the body. The loss of strength and mobility increases with age. Some people may eventually require mobility aids such as walkers, leg braces, or wheelchairs as they age.
• Chiari II malformation. The brain stem and cerebellum are abnormally situated causing them to push downward into the spinal canal or neck region. It is ordinarily observed from imaging scans of the brain in people affected with myelomeningocele, however, symptoms are not usually present. In cases where symptoms of Chiari II malformation are present, difficulty breathing, swallowing, and weakness in the arms are experienced. Surgery is required to relieve the pressure and facilitate easier breathing.
• Hydrocephalus. This condition is caused by the abnormal buildup of brain fluid surrounding the brain. This buildup of fluid can damage the brain unless a shunt is implanted allowing for the drainage of the fluid into the abdomen where it is eventually absorbed by the body. This condition is usually seen in people with myelomeningocele. The excess fluid can also be removed from the brain using a procedure called an endoscopic third ventriculostomy or ETV. This procedures creates an alternate exit path for the fluid to flow.
• Meningitis. Meningitis is a brain or spine infection that affects the meninges, the membrane covering the brain and spine. It is a life-threatening condition that can cause serious neurologic injury.
• Tethered cord syndrome. This condition can occur with any type of spina bifida. A tethered cord prevents the spinal cord and nerves from moving freely. The tethered cord attaches to tissue causing the cord to be pulled down. Loss of strength, feeling, and problems with bowel and bladder control are common symptoms. This can be due to conditions called fatty filum terminale, thick filum syndrome or occult tethered cord. Surgery may be considered as a treatment option for all of the above and can often treat these symptoms.
• Bowel & bladder incontinence. Most people with myelomeningocele and closed neural tube defects are affected by bowel and bladder dysfunction. People with this type of symptom may require assistance emptying their bladder or having regularly scheduled bowel movements.
• Learning disabilities. Children may have difficulty paying attention, understanding instructions, difficulty with memory, and inability to organize or problem solve. Others may have impaired motor skills. Children affected by learning disabilities related to spina bifida do well with individualized education plans (IEPs).
• Additional complications. People with myelomeningocele and neural tube defects may eventually experience skin ulcers, low bone density, male infertility, obesity, and kidney failure. People with this condition have an increased risk of precocious puberty, which causes premature adult-like changes to occur. Sleep apnea, possibly due to obesity, and depression are common symptoms for people with spina bifida.