Treatment usually is not needed for spina bifida occulta, the mildest form of spina bifida, and often not for meningocele. Treatment of the severe form of spina bifida manifesta called 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.

Prenatal surgery

Sometimes spina bifida manifesta 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 it 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 health professional about the advantages and risks of this surgery.

Initial treatment

A woman who knows that she is carrying a fetus that has spina bifida manifesta may need to have a cesarean section (C-section). She may choose to deliver her child in a large medical center where neonatal (new baby) surgery can be performed.

For the most severe form of spina bifida manifesta, initial treatment includes surgery to correct the protruding nerves and tissues. Surgery to correct the defect is usually performed within 36 to 48 hours after the baby is born. 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. Its placement is usually a simple procedure.

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.³

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

Nerve damage from spina bifida can lead to foot deformities, such as clubfoot, and hip deformities. Treatment of clubfoot may involve using a cast for the first 3 to 4 months of life to gradually straighten the foot. Corrective surgery may then be done by the time the child is 1 year of age. Hip deformities may be corrected surgically. But doctors recommend the surgery only if it is likely to allow the child to walk.