Spina bifida

Spina bifida is a congenital condition, present from birth, and which can usually be detected before a baby is born. ‘Spina bifida’ literally translates to ‘split spine’, and the condition occurs when a baby’s spinal cord does not develop correctly. It is called a ‘neural tube defect’.

There are two types of spina bifida, one being more common and less severe than the other. Around 5-10% of babies are born with a milder form of spina bifida, whilst the most severe form is very rare, with only around 1 in 2000 babies born with this condition.

Spina bifida symptoms are likely to be experienced throughout a person’s life; they may have some form of disability or difficulties with certain everyday tasks as they grow up. Some people may have physical or learning difficulties, or both. Some may use a wheelchair, others do not. Each person with spina bifida is an individual and will be affected differently, with different spina bifida symptoms. The condition is not just one experienced in childhood, and there are many adults living with spina bifida.

There are treatments for spina bifida available, but there is currently no cure, although research continues.

For a comprehensive spina bifida explanation, visit the “Shine” charity website and read their section on ‘What is Spina Bifida?’

As a foetus grows in the uterus, there is potential for certain body parts or bodily tissue to not form as they should. This is the case with spina bifida. Spina bifida occurs when a baby’s neural tube, which is the tube-like structure that eventually becomes a spinal cord leading from the brain, does not develop properly. The neural tube usually fuses together to create the baby’s vertebrae by around the 4th week of pregnancy. Sometimes, this does not happen, and there can be gaps in the spine and, in severe cases, spinal cord tissue can sometimes be pushing out of the vertebrae.

Exactly what causes spina bifida to occur in some babies and not others is not clear, but scientists believe there are several possibilities and risk factors, including:

For more information on what causes spina bifida, visit the NHS website.

The main types of spina bifida are:

Pregnant women in the UK are usually offered an anomaly scan around the 20th week of pregnancy. This scan looks in detail at the baby and checks the development of organs and body parts such as the spine. An open spina bifida, meaning there are visible gaps in the spine with a sac, spinal fluid or spinal cord coming through, is usually visible on the scan. If this is the case, the pregnant mother and her child will be referred on to a team that specialises in congenital conditions. A specialist will explain what this spina bifida diagnosis means, what spina bifida treatments are likely to be available once the baby is born, and the likely outlook for your baby’s health and quality of life in the future. Your doctor may also discuss with you options to end (terminate) your pregnancy.

For further information on diagnosis of spina bifida and what will happen next, download this NHS Patient Leaflet.

If your baby has been diagnosed with spina bifida before birth, you may be keen to understand what will happen when they are born. The Southampton Children’s Hospital website provides information about what to expect when you have a baby born with spina bifida.

Most babies born with an open spina bifida will require an operation quite soon after they are born, usually within the first day or two. This surgical procedure will put any spinal tissue or nerves that may be pushing out of the spine, back into place and close the gaps in the spine.

Babies with hydrocephalus will also need surgery to insert a shunt into the brain, which is a tube designed to drain fluid from the brain into the stomach or other area of the body. It is likely that a baby will require the shunt to be in place permanently. After many years, sometimes a shunt needs replacing and the surgery has to be repeated, but some people live with an original shunt.

These surgeries are essential to ensure a child lives, but they do not necessarily mean there will be no long-lasting symptoms of spina bifida. Some people may require other surgeries to improve incontinence or bladder and bowel problems, for example, some people undergo a colostomy procedure.

There are many therapeutic treatments available to help a baby, child and adult to manage their symptoms.

Physiotherapy may be able to help a baby develop muscle tone and the ability to roll, sit up and walk, then as a child or adult, it may help to manage muscle weakness, paralysis, joint and bone development problems and movement.

An Occupational Therapist (OT) may be able to assist with daily living tasks that are difficult due to having spina bifida, for example, dressing, using the toilet, or getting around. Read on to find out about how daily living aids may be able to help.

Some people with spina bifida do experience pain, which may stem from damage to nerves, or be musculoskeletal pain from muscles or bones. Speak to your GP if you are experiencing pain. There are medications available that may be able to relieve your pain, and complementary therapies such as acupuncture can also help. Some people also choose to learn how to manage pain with psychological techniques and your GP may be able to refer you to a pain management clinic or classes. To find out more about further treatments visit the NHS choices website.

Most people with spina bifida are able to live long and full lives. Some may have physical symptoms and disabilities that they need to manage throughout their lives, but with the right support, equipment and treatments, they are still able to do many things that people without the condition are able to do.

If you have a child with spina bifida, you may be concerned about what school they will go to and what they will achieve in their education, just as any parent does. Many children with spina bifida attend mainstream schools, and go on to further or higher education. Some require learning support, and some may have their needs better met at a special school. Shine has education advisors available to discuss with you how to find the right school, contact them here. Shine also provides a College and University Guide for students with Spina Bifida.

Sometimes it can help to hear other people’s stories and experiences of having spina bifida, or of having a child with spina bifida. The Great Ormond Street Hospital website provides a case study ‘Living with spina bifida’ that may be interesting to you. The Shine website also features a section called In Your Own Words which features several case studies from people of different ages living well and positively with spina bifida.

Looking after your health is really important if you have spina bifida, and can help prevent you developing other health conditions. For more advice on how best to do this, Shine provides a comprehensive leaflet about Taking Care of Yourself.

At Healthcare Pro, we are experts in daily living aids, which are products designed to help make everyday tasks easier if you have a healthcare condition or disability. Here, we provide a list of products that may be useful if you or your child has spina bifida symptoms and are finding some aspects of daily life difficult.

If you would like to speak to one of our Occupational Therapists to find if there are any daily living aids that may help you or someone you care for, please email them productadvice@healthcarepro.co.uk or telephone 0345 121 8111.

It is important for a child or adult with spina bifida to exercise regularly. The NHS provides lots of tips on how to get active with a disability if you are an adult that needs to increase their exercise levels, and the Change 4 Life website provides lots of ideas for accessible activities for children with disabilities and special needs.

If you think you or your child needs to exercise more, speak to your GP or specialist team for advice. You may be referred to a physiotherapist.

Eating a healthy diet is essential for everyone to remain healthy. Some people may experience spina bifida symptoms such as constipation and urinary tract infections (UTIs) so it is important to eat high fibre, vitamin rich foods and to drink plenty of water. The Change 4 Life website provides lots of advice about how to eat more healthily as a family.

Many people with spina bifida are able to work and young people with spina bifida are able to take up employment. The government’s Access to Work scheme aims to help people with a disability or health condition to find work by providing financial and practical support. Shine also provides information on Employment and Disability regarding rights, how to find suitable work, and voluntary work options.

Shine40plus – a community of people aged over 40 with both spina bifida and hydrocephalus who discuss a range of issues and experiences

Spina Bifida Connection – a US based forum for people affected by spina bifida

Shine Through Youth – a Facebook group with members from around the world, who come together to share their feelings and experiences of spina bifida

This is me Facebook group – a group run by the charity Shine which brings together 11 to 17 year olds with spina bifida and/or hydrocephalus

Contact – a charity for families with disabled children, which provides a Freephone helpline where families can get information, support and advice, as well as many guides on caring for children with disabilities

Newlife – a charity supporting disabled children and their families, by providing care services, a helpline, equipment grants, equipment loans and nursing support

NHS – medical information about causes, symptoms and treatments for spina bifida and related conditions such as hydrocephalus

Scope – a charity dedicated to supporting people with disabilities and their families, providing an online community, a confidential helpline and advice on many aspects of being a person with a disability of all ages

Shine – the leading UK charity for people with spina bifida and hydrocephalus, providing many networking opportunities for people to get together for support, as well as medical information and guides to the condition

Spina Bifida Hydrocephalus Scotland – created by parents of children with spina bifida, this Scottish charity provides information about the condition and providing services to families such as a helpline, workshops, youth clubs and respite