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Spina Bifida - Treatment Overview
Treatment usually is not needed
for the mild form of
spina bifida and often not needed for meningocele.
Treatment of the most severe form of spina bifida (myelomeningocele
) depends
on the specific problems caused by the spinal defect and may include surgery,
physical therapy, and the use of braces and other
aids. Some children will have problems day to day, and others won't.
Most babies born with severe spina bifida live through childhood or longer.2
A team of health professionals can help you address your child's needs. The team may include primary care doctors, nurses, surgeons, and therapists.
Prenatal surgery
Sometimes severe spina bifida can be surgically corrected before a baby is born (prenatally). The pregnant woman's uterus is entered with surgical instruments and the fetus's spine is repaired. This surgery, which is only done in specialized medical centers, is relatively new. And it is not yet known how much benefit this surgery provides in the long term. It also poses considerable risk for the fetus and mother and can cause premature birth. Because of these concerns, the surgery is considered experimental. Talk with your doctor about the advantages and risks of this surgery.
Initial treatment
If you know that you are carrying a baby who has severe spina bifida, talk with your doctor about whether to have a cesarean section (C-section) or not. Try to have your baby in a large medical center where neonatal (new baby) surgery can be done.
For the most severe form of spina bifida, initial treatment includes surgery on the exposed nerves and tissues. Some babies who have meningocele will also need surgery. Surgery is done to prevent spinal cord infection and protect the exposed nerve tissues from injury. It is usually performed within a few days after birth. Depending on the baby's health, surgery may be delayed for up to 6 weeks. Antibiotics are often given to prevent infection from developing inside the spinal cord or brain (encephalitis or meningitis).
Most babies with severe spina bifida have increased fluid around the brain (hydrocephalus). Treatment for hydrocephalus involves surgically installing a drainage tube called a shunt that relieves pressure on the brain by draining excess fluid into the abdomen. This keeps the swelling from causing further damage to the brain. A shunt may be necessary for the rest of the child's life.
Some babies also have a condition called a Chiari malformation of the brain. In a Chiari malformation, the lower part of the brain presses on the bones of the lower part of the skull and the upper spine. Pressure on the brain can sometimes be relieved with surgery to remove some of the bone.
In the first few weeks of life, a baby with severe spina bifida may need physical therapy to help strengthen the muscles by exercising the arms and legs. The parents will then continue to help their baby do the exercises at home.
Ongoing treatment
WebMD Medical Reference from Healthwise
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