Neurological and medical
Spina Bifida: Types, Causes, and What Care Involves
The three types and why the distinction matters, what is commonly involved, and where fetal surgery fits.
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Spina bifida occurs when the neural tube — the structure that becomes the brain and spinal cord — doesn't close completely during the first weeks of pregnancy, often before a pregnancy is known. Effects range from none at all in the mildest form to significant differences in mobility, bladder and bowel function, and sometimes learning. Folic acid taken before and during early pregnancy substantially reduces the risk, which is why supplementation is recommended for anyone who could become pregnant rather than only those planning to. Care is multidisciplinary and lifelong, involving neurosurgery, urology, orthopedics, physical and occupational therapy, and education support.
The three types
Spina bifida occulta — the mildest and most common; a small gap in the spine with the spinal cord and nerves usually undamaged and the skin intact. Many people have it without knowing, and it's frequently found incidentally on imaging done for another reason. Meningocele — the membranes around the spinal cord push through the gap, forming a sac; the cord itself is usually not in the sac. Myelomeningocele — the most significant form, where the spinal cord and nerves develop within the sac and are exposed; this is what most people mean by spina bifida. Where on the spine matters — generally, the higher the opening, the more of the body is affected.
Can spina bifida be prevented?
Folic acid before and during early pregnancy substantially reduces the risk of neural tube differences.3 The timing is the key detail: the neural tube closes in the first weeks, frequently before someone knows they're pregnant — which is why supplementation is recommended for anyone who could become pregnant, not only those actively trying. People with a previous affected pregnancy, or certain conditions or medications, may be advised a higher amount — a conversation with a doctor.
Latex allergy
People with spina bifida have a substantially raised rate of latex allergy, and it can be severe. This is one of the most practically important and most frequently omitted facts about the condition. It means latex precautions in medical and dental settings, awareness of everyday latex sources (balloons, some gloves, some elastic products), and telling every healthcare provider — including dentists — before any procedure. Many spina bifida clinics manage children as latex-avoidant from the start; if yours hasn't raised it, ask.
What's commonly involved
Mobility varies widely — some people walk without aids, some use braces or crutches, some use wheelchairs, and many use different means in different situations. Bladder and bowel nerve supply is frequently affected; management protects kidney health (which matters lifelong) and supports independence.
Two things to treat as urgent
Hydrocephalus — fluid build-up around the brain occurs in many children with myelomeningocele and is often managed with a shunt. Know the signs of shunt malfunction and treat them as urgent; your team should give you a specific list. Tethered cord — the spinal cord becoming attached and stretched as a child grows; signs include new or worsening weakness, changes in walking, back or leg pain, changes in bladder or bowel function, or scoliosis. New symptoms warrant prompt assessment.
Chiari II malformation — a structural difference at the base of the brain occurring in most children with myelomeningocele2; often causes no symptoms, sometimes needs treatment. Orthopedic — hips, feet, spine, and joint contractures. Learning — many children have typical intelligence; some have specific difficulties, particularly with attention, executive function, and non-verbal reasoning.
Fetal surgery
Prenatal repair of myelomeningocele is available at some specialist centers and, in the MOMS trial, improved certain outcomes (including reducing the need for a shunt) compared with repair after birth1 — for pregnancies meeting strict eligibility criteria. It isn't suitable for every pregnancy, and it carries its own risks, including a higher chance of preterm birth and risks to the mother. Whether it's an option depends on multiple factors and is a conversation with a specialist fetal medicine team — we include it because families frequently encounter it online and want to know whether it exists. It does; whether it's right in a given case is not something a website can answer.
What therapy helps with spina bifida?
Physical therapy — mobility, strength, positioning, orthotics, equipment, preventing contractures (find a physical therapist). Occupational therapy — daily living, hand function, seating, adaptive equipment, school participation (find an occupational therapist). Speech-language therapy where communication or feeding are affected (find a speech-language pathologist). Coordinated clinic care — multidisciplinary spina bifida clinics are the model most associated with good outcomes; ask whether one is accessible to you.
Frequently Asked Questions
Will my child walk?
It depends on the type and the level of the spine affected. Many people with spina bifida walk, with or without aids; others use wheelchairs, and many use different means in different situations.
What is a tethered cord?
The spinal cord becoming attached and stretched as a child grows. Signs include new weakness, changes in walking, back or leg pain, changes in bladder or bowel function, or scoliosis. New symptoms warrant prompt assessment.
What causes spina bifida?
The neural tube doesn't close completely in the first weeks of pregnancy. The cause is usually a combination of genetic and environmental factors. Low folate is a significant modifiable risk factor, but spina bifida also occurs where folic acid was taken correctly.
What is spina bifida occulta?
The mildest and most common form — a small gap in the spine with the cord and nerves usually undamaged. Many people have it without knowing and it usually causes no symptoms.
Does folic acid prevent spina bifida?
It substantially reduces the risk. Because the neural tube closes before many people know they're pregnant, supplementation is recommended for anyone who could become pregnant.
Does spina bifida always affect walking?
No. The effect depends heavily on the type and on where on the spine it occurs — spina bifida occulta often has no effect on movement at all, while myelomeningocele higher up the spine has more effect than lower down. Many children walk, some with orthotics or aids, and some use a wheelchair for part or all of the day. Mobility is planned around what a particular child needs, not predicted from the diagnosis alone.
Can spina bifida be treated before birth?
Prenatal repair is available at some specialist centers and has been shown to improve certain outcomes. It isn't suitable for every pregnancy and carries its own risks — a conversation with a fetal medicine specialist.
Why do people with spina bifida need to avoid latex?
Latex allergy occurs at substantially higher rates in people with spina bifida and can be severe. Precautions in medical and dental settings are standard, and every provider should be told.
Sources
- Adzick NS, Thom EA, Spong CY, Brock JW, Burrows PK, Johnson MP, et al. A randomized trial of prenatal versus postnatal repair of myelomeningocele. New England Journal of Medicine. 2011;364(11):993–1004. doi:10.1056/NEJMoa1014379 (PMID 21306277)
- Stevenson KL. Chiari type II malformation: past, present, and future. Neurosurgical Focus. 2004;16(2):E5. doi:10.3171/foc.2004.16.2.6 (PMID 15209488)
- Centers for Disease Control and Prevention — folic acid and the prevention of neural tube defects. Checked August 18, 2026.
- Spina Bifida Association — care guidelines. Checked August 18, 2026.
Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. If your child has lost skills they previously had, contact their doctor promptly.