Spina Bifida

Spina bifida is a congenital anomaly characterized by the formation of fissures or defects in the spine and nerves of the baby's spine. This disorder is triggered by the formation of imperfect spinal nerves in infants during pregnancy.

Under normal conditions, the embryo forms a neural tube which then develops in the spine and nervous system. If this process does not go smoothly, some vertebrae cannot close completely, creating empty space.

Spina Bifida
Vertebral structure
The spine protects the spinal canal which contains cerebral fluid and spinal cord. The spinal cord contains a collection of nerve fibers that connect the brain to various organs of the body. Inside the spinal canal, nerves are covered with a membrane called meningen. Outside the spine, there is skin tissue.

When a hole reaches a portion of skin tissue, for example on the skin of the lower back, brain fluid that surrounds the spinal cord can push it to form visible sacs on the lower back.
Spina bifida type

Spina bifida can be divided into 3 groups, depending on the location and size of the gap formed. Three types include:

  • Spina bifida occult. This type is among the lightest and most common because it only results in the formation of small spaces between the vertebrae. Spina bifida occultism usually does not affect the nerves, so sufferers tend to have mild symptoms or even no symptoms.
  • Meningocele In this type, the openings that are formed are large enough so that the protective membrane of the spinal cord detaches from several spinal openings and forms pockets. Meningocele is the rarest type of spina bifida.
  • Mielomeningocele. This is the most serious type of spina bifida, in which the baby's spinal canal opens along several vertebrae to form a sac containing a membrane and spinal cord that protrudes into the back region. In very serious cases, this bag doesn't even have leather. As a result, babies are vulnerable to life-threatening infections.

Causes of spina bifida and risk factors

The cause of spina bifida is not known with certainty, but it is thought that a number of factors can increase the risk of this disability. Among others are:

  • Folic acid deficiency. Having sufficient levels of folic acid, especially before and during pregnancy, is very important in reducing the risk of births in children with spina bifida. In contrast, folic acid deficiency is the most important triggering factor for spina bifida and other types of neural tube defects.
  • Heredity Parents who have children with spina bifida are more likely to find babies with the same disorder.
  • Gender. This disease is more often experienced by baby girls.
  • Some drugs, including valproic acid and carbamazepine, are used in the treatment of epilepsy or mental disorders, such as bipolar disorder.
  • Diabetes Women with diabetes have a greater risk of having a baby with spina bifida.
  • Obesity. Obesity before pregnancy will increase the risk of having a baby with neural tube defects, including spina bifida.

Women with these risk factors are encouraged to discuss this with their doctor so precautions can be taken, especially for women who are planning a pregnancy.

Spina Bifida Symptoms and Complications

The severity of symptoms experienced by each spina bifida victim can vary depending on the location of the cleft that forms in the spine. In addition to location, gravity also depends on the part that does not close completely.

Spina bifida can cause various symptoms. In general, symptoms that can occur are:

  • Mobility disorders. This condition is characterized by an inferior body part with muscle weakness or even paralysis.
  • Urinary and digestive disorders. People with spina bifida usually suffer from urinary incontinence or faecal incontinence due to nerve disorders that regulate the urinary tract and digestion.
  • Hydrocephalus. Conditions where there is accumulation of cerebrospinal fluid which can cause seizures and vision problems.

People with spina bifida also have a higher risk for meningitis and learning disabilities later in life. Language disorders, enumeration, and difficulty concentrating are examples of disturbances in the learning process that might occur.
Diagnosis of spina bifida

To detect the presence of spina bifida, the types of tests that are usually performed by doctors are blood tests and ultrasound.

Through a blood test, the doctor will check the levels of alpha-fetoprotein contained in the blood of pregnant women. High levels of alpha-fetoprotein can indicate that the fetus is susceptible to neural tube defects, especially spina bifida.

After that, the doctor will recommend an ultrasound to confirm the diagnosis. Spina bifida abnormalities can usually be detected by ultrasound, for example, some structural abnormalities in the baby's brain that indicate spina bifida.

Amniocentesis, which is a procedure for taking amniotic fluid, can also be recommended. The liquid will then be examined in a laboratory. Before taking this test, pregnant women are recommended to discuss the risks beforehand with the doctor, because this test tends to harm the fetus.

Tests in postnatal babies may also be needed. Babies born with spina bifida must undergo several tests, such as ultrasound, CT scan or MRI, to determine the severity and help determine the most appropriate treatment procedure.
Spina bifida treatment
Spina bifida requires different treatments, depending on the type of spina bifida that is felt, the severity of symptoms and the patient's condition.

Surgery is the first choice in treating the condition of spina bifida. Surgery is usually done immediately after the baby is born in 1-2 days. The aim is to fill in the gaps formed when handling hydrocephalus.

After surgery, people with spina bifida will also need additional treatment, including:

  • Therapy to help patients adjust to everyday life, such as occupational therapy or physical therapy.
  • Use of assistive devices, such as sticks or wheelchairs.
  • Treatment of urinary tract disorders and digestion with drugs or surgery.

Prevention of spina bifida


The main step to prevent the occurrence of spina bifida is to meet the needs of folic acid, especially during pregnancy. Consumption of this substance is generally recommended since before pregnancy. The recommended dosage of folic acid is 400 micrograms every day.

In addition to pregnant women and women who are planning a pregnancy, women of childbearing age are also encouraged to take folic acid supplements. This substance can also be obtained naturally from foods such as spinach, egg yolks, walnuts, and broccoli.

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