Spina Bifida

Treatment

Because many parts of your baby's body and nervous system can be affected by spina bifida, your child may need to see several doctors and therapists. In addition to surgery and physical therapy, your child may need treatment for inability to control urination and bowel movements (incontinence) and leg braces or other mobility aids. Your Mayo Clinic doctor will work with other specialists to develop an appropriate treatment plan based on:

• Your child's age, overall health and medical history
• The seriousness of your child's condition
• What the treatment team's experience suggests your child may experience in the future
• Your goals and preferences for your child

Surgery

Surgery is required soon after birth if your baby's spinal cord and coverings protrude through an open defect in the skin of the back (myelomeningocele).

• A neurosurgeon places the spinal cord and exposed tissue inside your infant's body and covers them with muscle and skin. If the area is large, your child's neurosurgeon may get help from a plastic surgeon.
• Often a baby born with a myelomeningocele also has an enlarged head due to pressure from trapped cerebral spinal fluid (hydrocephalus). If your child's head is enlarged, the doctor may insert a tube (shunt) to drain the excess fluid.
• Many babies with myelomeningocele have spinal cords that cannot grow properly as the child grows. Surgery on the spinal cord is occasionally required later to allow your child to regain a prior level of function.

Physical and occupational therapy

A baby who has a myelomeningocele already has irreparable nerve damage. That's why, as soon after surgery as possible, a physical therapist will teach you how to exercise your baby's legs and feet. These exercises help to maintain range of motion and stimulate muscle function to prepare your child for mobility. Some children with spina bifida will walk independently; others need leg braces and/or crutches or a walker. For independent mobility, some children will need to use a wheelchair. Occupational therapy can help children who have a problem with activities of daily living, such as eating or picking up small objects.

Bladder care

Because children who have spina bifida often have bladder problems, a urologist should evaluate your child's bladder function. If your child has a problem, the urologist may recommend medications, surgery or regular insertion of a small tube into the bladder (catheterization) to drain urine. Rehabilitation specialists can prescribe a bowel management program.