Tufts OpenCourseware
Authors: John Morgan, Bonnie F. Zimble

Spina Bifida:

Causes, Treatment andPrevention

Special Care in Dentistry
John Morgan, DDS
Tufts University School of Dental Medicine, 2008

Study Questions:     

  1. What three factors may play a role in unraveling the mystery of what causes Spina Bifida?

  2. Describe the major risks and benefits of in utero surgery, and experimental treatment for myelomeningocele?

  3. Which nutritional supplement can help to prevent Spina Bifida?

You may wish to visit the NINDS web site for more information on the causes, treatment and prevention of SB.  Selected information from the site is presented below. 

What causes Spina Bifida?

According to NINDS ...

“The exact cause of spina bifida remains a mystery.  No one knows what disrupts complete closure of the neural tube, causing a malformation to develop. Scientists suspect genetic, nutritional, and environmental factors play a role. Research studies indicate that insufficient intake of folic acid—a common B vitamin—in the mother’s diet is a key factor in causing spina bifida and other neural tube defects. Prenatal vitamins that are prescribed for the pregnant mother typically contain folic acid as well as other vitamins.”

Despite suspected genetic links, 95 percent of babies with SB and other neural tube defects are born to parents with no family history of these disorders.  Spina Bifida does not follow any particular pattern of inheritance. 

How is Spina Bifida treated? 

Spina bifida occulta usually requires no treatment, and meningocele can be repaired surgically. Spina bifida myelomeningocele usually requires surgery within 24 to 48 hours after birth, “to prevent infection from developing through the exposed nerves and tissue of the defect on the spine, and to protect the exposed nerves and structures from additional trauma.” (NINDS

One recent experimental approach is in utero surgery to enclose the developing baby’s spinal cord. While such surgery “cannot restore lost  neurological function, it may prevent additional loss from occurring.” In utero surgery carries risks both to fetus and mother: “The major risks to the fetus are those that might occur if the surgery stimulates premature delivery such as organ immaturity, brain hemorrhage, and death. Risks to the mother include infection, blood loss leading to the need for transfusion, gestational diabetes, and weight gain due to bed rest.” (NINDS)   

About 90 percent of children with myelomeningocele develop hydrocephalus. Without treatment, intellectual disability and other neurologic damage may result.  Other chronic complications associated with severe SB include obesity, gut and urinary tract disorders, psychological and sexual issues, and learning disabilities. Finally, between 18 and 73 percent of children with SB are allergic to latex (natural rubber). 

Can Spina Bifida be prevented? 

Research has shown that “by adding folic acid to their diets, women of childbearing age significantly reduce the risk of having a child with a neural tube defect, such as spina bifida. Therefore, it is recommended that all women of childbearing age consume 400 micrograms of folic acid daily.” (NINDS)  If all women in the Unites States took enough of the B vitamin folic acid every day before and during early pregnancy, up to 70 percent of neural tube defects (including SB) could be prevented.