What is spina bifida

Spina bifida literally means ‘split spine’. A fault in the development of the spinal cord and surrounding bones (vertebrae) can leave a gap or split in the spine. The spinal cord does not form properly, and may also be damaged. To help understand what spina bifida is, it is useful to explain the composition of the nervous system.

 

The central nervous system 

The central nervous system consists of the brain and the spinal cord. Everything we do, is controlled by the brain, including breathing and maintaining our body temperature. Our senses send information to our brain, which deliver messages to different parts of the body via the spinal cord and pairs of nerves that emerge at each vertebra.

 

The spine

The spine is made up of 33 bones or vertebrae. The vertebrae have two main functions - to protect our spinal cord, and to provide anchorage to our muscles.

The central nervous system and spine develop very early in the pregnancy, between the 14th and 23rd day after conception. Spina bifida occurs when the neural tube, the structure in the embryo that becomes the brain and spinal cord, fails to close correctly. The vertebrae also fail to form complete rings around the affected portion of the spinal cord. This leaves a gap at the back, involving one or more vertebrae, most commonly around waist-level.

 

What are the effects of spina bifida?

These vary greatly. Even people with a lesion of similar size and position may experience different impairments to varying degrees. Generally, people with lesions at waist level (L1 or above) will use wheelchairs full-time, while most people with lesions at the bottom of the spine (sacral) will be able to walk as adults.

Many children with lesions in the mid lumbar area walk during childhood, but choose to use a wheelchair for longer distances, sports, or as they get older. Splints often help support the feet and ankles.

Loss of skin sensation can lead to sores, especially on the feet, through injury or shoes that rub, and sometimes burns to the feet and legs are also common. It’s important to protect the feet, by having correctly fitting shoes or splints, covering hot pipes and carefully checking the bathwater before getting in.

Bladder and bowels are very often affected, even in people with sacral lesions. Loss of sensation, and lack of coordination between the bladder muscle and the outlet (bladder neck) can lead to difficulty filling and emptying the bladder. Infections, leaking and frequency of passing urine can occur, but intermittent catheterisation, and medication to relax the bladder can be a big help. Bowel issues such as constipation or leakage can often be helped with irrigation and/or medication.

Because spina bifida changes the way the brain develops, there can be an impact on learning and behaviour. NB. Children with spina bifida should have their childhood vaccinations just like other children.