Spina Bifida

Occult spinal dysraphism (tethered cord syndrome) is a series of spinal and spinal cord abnormalities that comprise a continuum of severity. In the least severe forms, this syndrome can require a simple surgery that is curative. In the more severe forms, a child may need ongoing monitoring and intervention throughout their lives.

Adult patients with tethered cord syndrome may have back abnormalities along the midline of their backs. They may also develop benign fatty collections within the spinal cord (lipomyelomeningocele) which also can cause tethered cord syndrome which requires evaluation and treatment.

This is the most severe form of spina bifida, where the spinal cord is visible outside of the body at birth. All children with myelomeningocele require urgent surgery after birth and up to 90 percent of patients will require treatment for hydrocephalus — usually an implanted shunt — at some time in their lives.

In most cases, spina bifida is diagnosed during routine pregnancy exams before a baby is born, such as:

• An ultrasound
• A blood test that measures levels of alpha-fetoprotein (AFP). High levels may indicate your baby has spina bifida
• A test to screen for certain conditions using a sample of fluid from the sac that surrounds the unborn baby (amniocentesis)

After your child is born, further testing may include:

• MRI
• CT scan
• X-rays

Treatment depends on the type of spina bifida and the severity of the condition. Treatment may include:

• Surgery soon after diagnosis
• Assistive devices such as crutches, braces or wheelchairs
• Physical therapy
• Bladder and bowel management