Spina bifida care at Mayo Clinic

Doctor with baby

Mayo Clinic's pediatric experts provide the highest quality care for children with spina bifida and any complications.

Your Mayo Clinic care team

At Mayo Clinic, you can expect the best care from our multispecialty team of pediatric experts on spina bifida. Depending on age and individual needs, the team of experts may include pediatric or adult specialists in neurosurgery, neurology, urology, orthopedic surgery, radiology, physical medicine and rehabilitation, pediatric rehabilitation, clinical genomics, maternal and fetal medicine, pediatric surgery, and others.

Mayo Clinic has significant expertise and experience in caring for children and adults who have spina bifida, treating more than 290 people annually.

Advanced diagnosis and treatment: Spina bifida surgery before birth

When a spina bifida diagnosis is made before birth, the mother will need a comprehensive evaluation to determine treatment options. Mayo Clinic experts may offer in utero spina bifida surgery. This complex procedure involves a team from several Mayo Clinic specialties, including pediatric neurosurgeons, specialists in obstetrics and gynecology, and maternal and fetal medicine specialists.

Using ultrasound as a guide, surgeons expose the pregnant mother's uterus surgically, open the uterus, repair the baby's spinal cord and close the mother's incision. When done by the experienced specialists at Mayo Clinic, prenatal surgery typically results in significantly less disability for the child with spina bifida.

In utero spina bifida surgery

Narrator: In utero spina bifida surgery is a complex procedure which requires a team of experts from many Mayo Clinic specialties. Before the operation begins, the mother is put under deep general anesthesia to make sure both she and the baby are asleep.

Using ultrasound as a guide, surgeons make the first incision to access the uterus. Then in cases where the placenta blocks access to the uterus, the uterus is moved out of the mother's abdomen and turned.

Doctors make a one centimeter incision in the uterus and use a special stapler to secure blood flow. Then they fill the uterus with a solution.

The fetus floats to the top of the uterus and the spina bifida is exposed. Now doctors can begin the repair.

First, they close what's called the neural plaque code. Second, they suture the dura mater. Third, they close the skin.

Then they close the uterus, replace that into the mother's abdomen and close her incision.

Through new innovations, Mayo Clinic surgeons are repairing spina bifida prior to birth with the use of a fetoscope. This vastly improves the life of the baby and enables the mother to deliver vaginally and closer to term.

Surgery prior to birth can often be offered for severe congenital anomalies such as spina bifida. Congenital anomalies are typically diagnosed around 20 weeks during the recommended fetal anatomy scan. Once the condition is diagnosed, a multidisciplinary center can offer the best treatment options, with various specialists coming together using the latest technology and techniques. Early intervention is extremely important, and involving a specialized team sooner helps teams plan and prepare for treatment options.

Mayo Clinic specializes in minimally invasive approaches that improve overall outcomes. Using a multidisciplinary approach, experts for both the mother and the child come together. These include experts in in maternal and fetal medicine, obstetricians, cardiologists, neurologists, and others.

Fetoscopic spina bifida repair

Narrator: During fetoscopic surgical repair, an incision is made in the abdomen to expose the uterus. Using ultrasound, the location of the placenta is identified to determine safe locations for insertion of the endoscopic trocars. The baby's back is then positioned facing up, and gas or air is added to the uterus to create a uterine environment that's half gas and half amniotic fluid. This allows the baby to float in the amniotic fluid with its back exposed for the procedure.

Two ports are inserted through the wall of the uterus. Through a tiny telescope, the spina bifida defect is visualized. The membrane of the cyst is sharply cut, and the neural placode is released from the surrounding tissue. Then the dura mater and all layers of the muscle and skin are closed over the top of the neural elements, resulting in a watertight seal. The gas is replaced by fluid to maintain the amniotic fluid volume. Finally, the instruments and ports are removed, and the maternal abdomen is closed to complete the procedure.

Fetoscopic surgery on fetus Spina bifida fetoscopic surgery

Fetal surgeons access the uterus through an incision in the mother's abdomen, repair the spina bifida defect and close the opening in the baby's back and the mother's incision.

Doctor viewing computer image of the spine

To aid in treatment planning and decisions, a model of the patient's spine can be generated by computer medical imaging and then printed on a 3D printer.

Spina Bifida Clinic

At Mayo's campus in Rochester, Minnesota, the Spina Bifida Clinic coordinates care for children and teenagers with complex conditions of the spine, spinal cord, brain, bowel and bladder. When they reach adulthood, they can transition to a Mayo health care team for adults with spina bifida.

You and your child will likely see many experts over the course of the first visit. This multispecialty team approach results in a personalized treatment plan and patient-centered care. This plan may include surgery, medication, therapy, special equipment and follow-up appointments with specialists.

Expertise and rankings

Girl walking on crutches

Mayo Clinic is consistently recognized by external organizations for providing outstanding care. These endorsements reinforce our commitment to provide expert, compassionate care to both children and adults.

Nationally recognized expertise

Mayo Clinic in Rochester, Minn., and Mayo Clinic in Jacksonville, Fla., rank among the Best Hospitals for neurology and neurosurgery in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Phoenix/Scottsdale, Ariz., is ranked high-performing for neurology and neurosurgery by U.S. News & World Report.

Mayo Clinic in Rochester, Minn., and Mayo Clinic in Phoenix/Scottsdale, Ariz., are ranked among the Best Hospitals for orthopedics by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., is ranked highly performing for orthopedics. Mayo Clinic also ranks among the Best Children's Hospitals for orthopedics.

Mayo Clinic in Rochester, Minn., is ranked No. 1 for urology in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Phoenix/Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals in the nation for urology by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for urology.

Pediatric experts

Mayo Clinic's pediatric experts provide the highest quality care for children with spina bifida and any complications. This experienced multispecialty team includes specialists from pediatric neurosurgery, pediatric neurology, pediatric urology, pediatric orthopedic surgery, pediatric rehabilitation and other areas.

Children who need hospital care receive treatment at Mayo Eugenio Litta Children's Hospital, consistently recognized as one of the best children's hospitals in the nation.

Fetal and maternal care in Minnesota

The Mayo Clinic offers a coordinated, multispecialty team approach to help women experiencing high-risk pregnancies. Mayo Clinic experts specializing in fetal and maternal care use imaging techniques prenatally to accurately diagnose babies with birth defects, such as spina bifida, and then connect parents with the necessary specialists.

This team of physicians and nurses helps coordinate any necessary intrauterine treatment, plans the route and timing of delivery, and provides a smooth care transition for the newborn infant.

NICU and NICU Follow-up Clinic

Mayo Clinic's Newborn Intensive Care Unit (NICU) specializes in family-centered care of premature and critically ill newborn infants. Families are welcome at the baby's bedside and will find many support spaces throughout the unit, such as family waiting areas and rooms, parent sleep rooms, and breast-feeding rooms.

Mayo's NICU Follow-up Clinic ensures continuity of quality care after the baby's discharge from the NICU.

Continuity of care

Mayo Clinic provides lifelong care for spina bifida, so your child can transition to adult care for follow-up to ensure continued quality care.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

For more information on visiting Mayo Clinic, choose your location below:

Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

More information about billing and insurance:

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March 17, 2021


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