Spina bifida is a congenital spinal abnormality which usually develops during the first month of fetal growth. The condition comes in three main varieties and a host of possible severities.
The most common and least symptomatic form is Bifida Occulta. The least common form is Meningocele. The most severe and functionally affective variety is Bifida Cystica. The name of the condition comes from the Latin root term which literally means split spine.
One factor links all varieties of spina bifida. They all involve abnormal holes in the vertebral bones, sometimes exposing the usually protected nerve structures to the rest of the body’s influence and interactions. Minor cases are almost universally nonissues, while significant cases can be dire in their potential effects.
Patients diagnosed with having any symptoms related to their bifida development are highly encouraged to seek care and advice from a specialist in the dorsal structures, be it a spinal neurologist or a spinal orthopedist.
Bifida is characterized by a developmental abnormality in the neural tube of a new fetus. The neural tube eventually becomes the spinal structures and in the case of bifida conditions, grows with an abnormal opening. This opening can cause any of the various bifida conditions to occur.
In the case of Spina Bifida Occulta, one or more of the vertebral bones will be affected and will demonstrate an opening in the outer surface. This opening will not affect the spinal cord or nerves in the vast majority of patients and should not cause any unusual or painful symptoms.
In the case of Meningocele, the spinal vertebrae might have openings on the inner or outer surface and will demonstrate cystic formation of sacs typically filled with cerebrospinal fluid. The spinal cord and nerves should not be affected by this condition and the patient should not experience any pain.
Cystica is the worst possible variety and is almost always symptomatic. In a cystica patient, the spinal cord and nerves will actually protrude from the spinal bones and suffer a complete or partial loss of functionality.
Occulta patients rarely have any symptoms due to their abnormal spinal formation. Many people with occulta do not even know that they have the condition at all.
Meningocele patients will typically have visual deformity, especially if the cystic formation is on the outer surface of the spine. Most patients will not have any pain and should live normal lives.
Cystica patients will undoubtedly suffer neurological effects from their condition. Many will be neurologically impaired, suffering from a loss of sensory function and motor ability below the region affected by the defect. Some will endure a complete loss of nerve function below the defect, entailing a complete paralysis condition. Organ and systemic dysfunction is common, including the inability to control the bladder and bowels. Other physical deformities are also common in bifida cystica patients, since the lower body will not receive proper nerve signal necessary for normal growth.
Any patient with bifida might also experience tethered spinal cord syndrome. It is not known if this condition is directly linked to bifida conditions or is simply a coincidental associated syndrome. In cases of symptomatic occulta or meningocele, tethered cord syndrome is often to blame for the pain, rather than the bifida condition itself.
Most patients will demonstrate the occulta form of bifida. While this condition is rarely symptomatic, it is often used as a scapegoat to explain otherwise idiopathic forms of back pain. Occulta patients sometimes suffer a nocebo effect from the diagnostic process, which can bring on psychosomatic back pain later in life.
A good general rule states that the higher the deformity exists on the back and the larger the abnormal vertebral openings, the greater the chance of suffering some ill effects from the condition. Most patients with occulta will never know they even have the defect, unless informed by their doctor.
All forms of severe bifida increase the chances of suffering from other spinal abnormalities, such as scoliosis, kyphosis or lordosis, as well as other potentially problematic health conditions.