What is spina bifida and what are its main types?

Spina bifida is a congenital disorder that occurs due to incomplete development of the spine during the first month of pregnancy. In this condition, the neural tube—the structure that later develops into the brain and spinal cord—fails to close completely. This leaves openings in the spinal bones that may cause nerve and spinal cord damage. Although there is no cure for this condition, medical advancements allow most affected individuals to live long lives with appropriate medical care [1].

The Four Main Types of Spina Bifida

The severity of spina bifida varies depending on the type, which is medically classified into four main categories:

• Spina Bifida Occulta: This is the most common and mildest form. It involves a defect in the formation of one or more vertebrae, but the opening remains covered by a layer of skin. This often makes it invisible and asymptomatic, and it is usually discovered incidentally via X-ray [1].
• Closed Neural Tube Defects: This group includes various disorders affecting the tissues surrounding the spinal cord, such as fat, bone, or the meninges. Affected individuals may experience leg weakness and bladder and bowel control disorders, often requiring surgical intervention in childhood [1].
• Meningocele: This occurs when the membranes surrounding the spinal cord (the meninges) protrude through an opening in the spine, forming a sac filled with cerebrospinal fluid. This sac does not contain nerves, and the individual may exhibit only mild symptoms [1].
• Myelomeningocele: This is the most severe form of spina bifida, where spinal cord tissues and nerves protrude through an opening in the spine within a visible sac. It is often associated with brain structure abnormalities, lower limb weakness, and bowel and bladder issues [1].

Diagnosis and Medical Management

In many cases, especially within advanced healthcare systems, signs of spina bifida can be detected before birth. A doctor can perform a maternal alpha-fetoprotein (AFP) blood test between weeks 16 and 18 of pregnancy, as elevated levels indicate a potential neural tube defect [2]. Additionally, ultrasound imaging during the second trimester is a precise tool for detecting these defects, and amniocentesis may be used in some cases to gather further data [1].

Treatment depends on the type of condition; in cases of myelomeningocele, surgery may be performed to close the opening either in utero or shortly after birth to reduce infection risk and protect the nerves. Lifelong care requires close follow-up by a specialized medical team to manage bladder and bowel function and provide mobility support through physical therapy or assistive devices like braces and walkers when needed. Parents should consult a doctor immediately upon noticing any deterioration in muscle strength or changes in the child's vital function control, as ongoing monitoring is the cornerstone for preventing complications such as kidney damage or hydrocephalus [1]. To learn more about this topic, please read our article on Spina Bifida: Causes, Diagnosis, and Lifelong Management (Arabic).

Medical references

• Spina Bifida
• Alpha-Fetoprotein (AFP) Test