What is spina bifida

The neural tube usually closes between days 24 and 28 following conception during a process called neurulation. Spina bifida is a descriptive term applied to a group of neural tube defects associated disruption of neurulation leading to failure of posterior fusion of vertebral osseous elements (Fig. 62-6). Spina bifida is classified into two main types: • Spina bifida occulta: Intact skin overlies the underlying anomaly, which ranges from an osseous defect involving the posterior lamina without associated structural or neurologic significance to clinically significant involvement of

Figure 62-6. Sagittal views of spina bifida malformations. Magnetic resonance image and corresponding views showing A and B, Spina bifida occulta. C, Spina bifida cystica. D, Meningocele and meningomyelocele). CSF, cerebrospinal fluid. (From Haines DE. Fundamental Neuroscience for Basic and Clinical Applications. 3rd ed. Philadelphia: Churchill Livingstone; 2006.)

rSac containing: Meninges + CSF Spinal cord

Viscera Meningocele Meningomyelocele

Spina bifida occulta Spina bifida cystica

Viscera Meningocele Meningomyelocele

Spina bifida occulta Spina bifida cystica

neural and meningeal structures with significant neurologic sequelae (e.g., diastematomyelia, lipomyelomeningocele, anterior sacral meningocele, tethered filum terminale) • Spina bifida cystica: A mass extrudes through the defect and overlying skin. The mass may contain meninges and CSF (meningocele) or meninges, CSF, and spinal neural tissue (myelomeningocele). The spectrum of conditions may be detectable with prenatal imaging, is visible at birth and may be associated with severe neurologic sequelae. These sequelae may include hydrocephalus, neurogenic bowel and bladder dysfunction, and varying degrees of lower extremity paralysis.

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