Spina Bifida

Our fetal spina bifida closure team. From left: Russell Miller, MD; Neil Feldstein, MD; Rosalie Ingrassia, NP; Lynn Simpson, MD; Vincent Duron, MD; Laurence Ring, MD
Our fetal spina bifida closure team. From left: Russell Miller, MD; Neil Feldstein, MD; Rosalie Ingrassia, NP; Lynn Simpson, MD; Vincent Duron, MD; Laurence Ring, MD

What is spina bifida?

Spina bifida is the most common neural tube defect (NTD), and birth defect of the brain and spinal cord. The most severe form of spina bifida, known as myelomeningocele, results in a sac-like lesion along the spine where the spinal cord and the nerves are open and exposed. Less serious forms of spina bifida are meningocele—in which the spinal cord itself is not damaged but its protective covering is exposed—and spina bifida occulta—in which only the bones of the spine are malformed but the nerves and spinal cord are normal and covered by skin. Spina bifida occurs in approximately one to two out of every 2,000 births.

How is this condition managed during pregnancy?

Pregnancy will be monitored by screening tests including routine ultrasounds, fetal echocardiogram, and MRI. Genetic counseling is recommended due to the association of spina bifida with additional abnormalities and genetic conditions. Your prenatal care will be managed by a maternal-fetal Medicine specialist, an obstetrician with special training and expertise in high risk pregnancies.

How is this condition managed after delivery?

Surgery to close the spine is usually performed within the first few days of newborn life. If there are additional abnormalities, such as increased fluid in the brain (hydrocephalus), a shunt will be surgically placed to help drain excess fluid and relieve pressure. The long term prognosis, including the degree of disability, is largely dependent on where along the spine the nerves were damaged, the size of the lesion, whether other birth defects are present, and how aggressively the spina bifida is treated. In general, the lower the lesion is along the spine, the better the outlook.