Spina Bifida occulta usually requires no treatment. Meningocele, which does not involve the spinal cord, can be repaired surgically, usually with no paralysis. Most children with meningocele develop normally. However, affected children should be evaluated for hydrocephalus and bladder problems so they can be treated promptly, if necessary. A baby with the most severe form of Spina Bifida usually is operated on within 24 to 48 hours after birth. Doctors surgically release the spinal cord, replace it in the spinal canal and cover it with muscle and skin. Prompt surgery helps prevent additional nerve damage from infection or trauma. However, nerve damage that has already occurred cannot be reversed and limb paralysis and bladder and bowel problems usually remain. As soon after surgery as possible, a physical therapist teaches the parents how to exercise their baby’s legs and feet to prepare for walking with leg braces (callipers) and crutches. Studies show that about 70 percent of affected children are able to walk with or without these devices. The rest need a wheelchair. (The severity of paralysis is largely determined by the specific spinal nerves involved. In general, the higher the cyst on the back, the more severe the paralysis. About 80 percent of Spina Bifida cysts are located in the lower back’s lumbar and sacral regions. Most of these children can walk with aids. Children with cysts above this level are more likely to need a wheelchair.) Most children with severe Spina Bifida have a tethered spinal cord, meaning that the spinal cord does not slide up and down with movement as it normally should, because it is held in place by surrounding tissue. While most children develop no symptoms from a tethered cord, some suffer a progressive loss of function in their legs, and a few develop scoliosis (curvature of the spine). If the spinal cord is surgically untethered soon after these symptoms begin, a child should return to his or her usual level of functioning.
According to the Spina Bifida Association of America (SBAA), between 18 and 73 percent of children with Spina Bifida are allergic to latex (natural rubber), possibly due to intense exposure during multiple surgeries and medical procedures. Symptoms may include watery eyes, wheezing, hives, rash, and even life-threatening anaphylactic reactions. Doctors should use only nonlatex gloves and equipment during medical and surgical procedures on individuals with Spina Bifida. Affected individuals and their families should avoid latex items in the home and community (a list is available from the SBAA).
With treatment, children with Spina Bifida usually can become active individuals. Most affected women can have children, although such pregnancies are considered “high risk.”
A condition called hydrocephalus may accompany this, although not all the time. A child may also develop hydrocephalus and not have Spina Bifida.