AI Summary Overview
Quick Glance: Common Spina Bifida Symptoms
The symptoms of spina bifida vary depending on the type (spina bifida occulta, meningocele, or myelomeningocele) and the severity of the spinal defect. The common symptoms of spina bifida include:
-
A visible sac or opening on the back of open spina bifida
-
Weakness or paralysis of the legs
-
Reduced sensation in the legs or feet
-
Difficulty walking or delayed motor development
-
Difficulty controlling or emptying the bladder
-
Constipation or bowel-control problems
-
Clubfoot or other leg and foot deformities
-
Scoliosis or other spinal abnormalities
Spina Bifida Symptoms That Should Not Be Ignored
People with established spina bifida should be assessed when new or progressive symptoms develop. Some of the symptoms that should not be ignored include:
| Symptom | What It May Indicate |
| Gradually worsening leg weakness | Possible tethering or deterioration in spinal nerve function |
| New difficulty walking or a noticeable change in walking pattern | Changing neurological or orthopaedic function |
| Increasing back or leg pain | Possible tethered cord or another spinal problem |
| New or worsening bladder leakage or difficulty emptying the bladder | Changes in neurogenic bladder function |
| Increasing constipation or new bowel-control problems | Changes in nerve control of the bowel |
| Progressive foot deformity or worsening scoliosis | Changing muscle balance or orthopaedic involvement |
| Repeated urinary tract infections | Incomplete bladder emptying or other urinary complications |
| Unnoticed sores or persistent redness on areas with reduced sensation | Skin injury that may worsen because pain sensation is reduced |
Why Do Spina Bifida Symptoms Occur?
Symptoms of spina bifida occur when there is incomplete closure of the neural tube or incomplete formation of the vertebral arches of the fetus during early pregnancy, disrupting the development and protection of the spinal cord and nerves.
As these nerves carry signals between the brain and the body, any structural damage can interrupt those vital signals. This disruption often causes weakness or paralysis of the legs, reduced sensation and difficulty walking.
If the nerves controlling the bladder and bowel are affected, this may cause problems such as urinary incontinence, difficulty emptying the bladder, constipation, or bowel incontinence. The nerve-related muscle imbalance can further lead to orthopaedic issues such as clubfoot, hip dislocation, scoliosis and joint contractures.
In the more severe forms of spina bifida, complications such as hydrocephalus, Chiari II malformation, or tethered cord syndrome may occur. These may lead to symptoms like rapid head growth, drowsiness, vomiting, back pain, worsening leg weakness, changes in walking and worsening bladder or bowel function.
Spina Bifida Symptoms That Require Immediate Medical Attention
The following symptoms of spina bifida may indicate a potential medical emergency:
-
Fluid leaking from a spinal swelling in a newborn
-
Fever, redness, swelling, or pus near an open spinal lesion
-
Rapid enlargement of an infant's head
-
Bulging or tense soft spot (fontanelle) in a baby
-
Repeated vomiting with drowsiness or irritability
-
New or rapidly worsening weakness in the legs
-
Sudden loss of bladder or bowel control, even in a stable individual
-
Severe back pain and rapidly worsening neurological symptoms
-
Reduced consciousness or seizures
-
Difficulty breathing or feeding in an infant due to hindbrain abnormalities associated with Chiari II malformation
Hydrocephalus requires close monitoring because excess cerebrospinal fluid can increase pressure and injure the brain. Shunts can also become blocked or infected.
Symptoms of Spina Bifida Based on Type
Below are the types of spina bifida, along with their symptoms:
| Type | Symptoms |
| Spina Bifida Occulta (Closed Defect) | Usually causes no disability or overt symptoms; however, subtle skin markings over the lower spine such as a tuft of hair, a deep dimple, a birthmark, or a soft fatty lump (lipoma) may be visible. |
| Meningocele | A fluid-filled sac protrudes through the spinal opening, but the spinal cord is not inside the sac; neurological symptoms are usually absent or mild |
| Myelomeningocele (Open Spina Bifida) | An open or sac-like spinal defect containing spinal cord and nerves; may cause leg weakness or paralysis, reduced sensation, bladder and bowel dysfunction and orthopaedic problems |
Symptoms of Spina Bifida in Children
Children may experience different symptoms from adults because signs can emerge as they grow and reach developmental milestones. Babies born with myelomeningocele usually have a visible spinal defect, whereas children with spina bifida occulta may not develop symptoms until later in childhood.
Some of the symptoms that parents may notice include:
-
A sac or open area on the baby’s back
-
Weak or poorly moving legs
-
Reduced response to touch in the legs or feet
-
Clubfoot or unusual leg position
-
Delayed sitting, crawling or walking
-
Difficulty controlling or emptying the bladder
-
Persistent constipation or bowel-control problems
-
Changes in walking or leg strength as the child grows
Children with hydrocephalus may also develop rapid head growth, vomiting, irritability or unusual sleepiness. New loss of strength, worsening walking, or changes in bladder function later in childhood may suggest a tethered cord and should be assessed.
Can You Have Spina Bifida Without Symptoms?
Yes, spina bifida occulta can occur without symptoms and is often discovered incidentally on a spinal X-ray or during imaging performed for another reason. The vertebral defect is usually small, and the spinal cord is often unaffected, so most people do not have leg weakness, bladder or bowel dysfunction or back pain.
However, not every hidden spinal abnormality is a simple case of spina bifida occulta. Other forms of closed spinal dysraphism can involve the spinal cord and may later cause weakness, pain or bladder and bowel changes. Therefore, persistent neurological symptoms need appropriate evaluation.
When Can Spina Bifida Symptoms Become Life-Threatening?
Spina bifida can become life-threatening if complications affect the brain, breathing or other vital organ functions, especially in children with myelomeningocele and associated hydrocephalus or Chiari II malformation.
The following symptoms can become life-threatening situations if not given prompt medical attention:
| Symptom | Why It Is Serious |
| Rapid head growth with repeated vomiting, unusual drowsiness or a bulging fontanelle | High fluid pressure in the brain can cause brain injury, seizures, or coma if untreated or if a shunt becomes blocked. |
| Severe headache, vomiting, marked sleepiness or behavioural change in a person with a shunt | A blocked or infected shunt may lead to the rapid onset of headache, vomiting, drowsiness, and brain herniation if treatment is delayed. |
| Fever with redness, swelling or discharge around a spinal wound or shunt | Infection may involve deeper tissues, cerebrospinal fluid or the bloodstream. |
| Noisy breathing, difficulty swallowing, choking or episodes of stopped breathing | Brainstem dysfunction associated with Chiari II malformation can interfere with breathing and airway protection. |
| High fever with vomiting, marked weakness or confusion in a person with bladder dysfunction | A urinary infection may have spread to the kidneys or bloodstream and can become severe. |
| Seizures, severe drowsiness or reduced consciousness | These may indicate severe neurological deterioration and require emergency assessment. |
How are Spina Bifida Symptoms Diagnosed?
Spina bifida may be diagnosed before birth or after delivery. The tests used depend on the type of defect and whether neurological, bladder or brain complications are involved.
These assessments and their purpose are described in brief in the table below:
| Diagnostic Test or Assessment | Purpose |
| Prenatal ultrasound | Can detect many open spinal defects before birth |
| Maternal serum alpha-fetoprotein (AFP) screening | A raised level may suggest an open neural tube defect and prompt further assessment |
| Newborn physical examination | Looks for an open spinal defect, sac, abnormal skin marking, leg weakness or other signs |
| Spine ultrasound in selected young infants | Can assess spinal structures when a closed spinal abnormality is suspected |
| Spine MRI | Provides detailed images of the spinal cord and may identify tethering or other spinal abnormalities |
| Brain ultrasound, MRI or CT | Assesses hydrocephalus or other brain abnormalities when clinically indicated |
| Neurological examination | Checks strength, movement, reflexes and sensation |
| Renal and bladder ultrasound | Assesses the urinary system for effects of neurogenic bladder rather than diagnosing spina bifida itself |
| Urodynamic testing | Measures bladder storage, pressure and emptying when a neurogenic bladder is suspected or monitored |
| Orthopaedic assessment and imaging | Evaluates scoliosis, hip problems, foot deformities and other musculoskeletal effects |
FAQs
-
Q1. What is the first symptom of spina bifida?
Ans: The first signs of spina bifida may include skin changes such as a hairy patch or skin dimple over the spine in spina bifida occulta and a visible sac or opening on a newborn’s back in myelomeningocele. -
Q2. Does every baby with spina bifida develop hydrocephalus?
Ans: Spina bifida does not always cause hydrocephalus. It is particularly associated with more severe open forms such as myelomeningocele. -
Q3. Which spina bifida symptoms should never be ignored?
Ans: Do not ignore the new or worsening leg weakness, sudden loss of bladder or bowel control, rapidly increasing head size, vomiting, or irritability in a child with spina bifida, or any sign of infection around the shunt or back, and seek immediate medical attention.
