Spina Bifida

Concept map

SPINA BIFIDA

Health

PromotionCognitive/

Behavioral

Impacts

Spina Bifida
Occulta (SBO)

Spina Bifida
Cystica (SBC)

All women of childbearing age,
whether they are trying to

conceive or not, should consume
0.4mg of folic acid per day to

prevent having a child with spina
bifida; women who have

previously had a child with spina
bifida should consume 4mg of

folic acid per day

1,645 babies are born
with

spina bifida

every year in the

United States
Hispanic women

have the highest rate
of having a child with

spina bifida

Prevention

Health
MeasuresImpaired mobility and

urinary and bowel
incontinence can cause
delays in developmental
milestones, such as toilet
training; spina bifida can

also have impacts on long-
term milestones like forming

sexual relationships and
child-bearing

Complications such
as hydrocephalus,

seizures, and
infections can

cause cognitive
delays

Assessment
Findings

Lab
Studies

Imaging

Diagnosis

Environmental

Factors

Treatment

Diagnosis is based on clinical
manifestations and examination

of the meningeal sac
Neurological exams can

determine the impact on bowel
and bladder function and the
neuromuscular affect on the

lower extremities

MRIs, CTs, and ultrasounds
can be used to evaluate the

brain and spinal cord
Prenatal ultrasounds can also
be used to scan the uterus for
signs of neural tube defects

prior to birth

Amniotic fluid can be
tested during pregnancy
for indications of neural
tube defects, such as
elevated levels of α-

fetoprotein

Signs &

Symptoms

SBO is not always
apparent on inspection

and may be
asymptomatic

Possible cutaneous
manifestations include: a

skin depression or dimple,
dark tufts of hair, or port-

wine nevi

A visible, external, sac-like
protrusion on the lumbrosacral area
S/S vary based on the degree and
location of the spinal defect, and

can include:
Sensory impairment, partial

paralysis of the lower extremities,
overflow incontinence, lack of bowel
control, bladder and anal sphincter
paralysis, rectal prolapse, and

joint deformities
Demographics

Fecal continence can
often be restored with

proper nutrition (adequate
fiber intake), regular
bowel training, and

constipation prevention

50-70% of neural tube
defects could be

prevented with adequate
folic acid intake; thus, lack
of education and access
to quality, fortified foods
greatly increase the risk
of giving birth to a child

with spina bifida

Surgical closure of the sac is
recommended within the first 24 hours to
prevent complications such as infection,

rupture, and trauma to the exposed tissue
Broad-spectrum antibiotics are

initiated early for infection prevention
Physical therapy may be necessary if
there are musculoskeletal deformities

Clean intermittent catheterization,
temporary urinary diversion, or

augmentation enterocystoplasty may be
required depending on the level of

bladder dysfunction

A genetic anomaly resulting
in a fissure in the spinal

column, leaving the meninges
and spinal cord exposed.

Spina bifida is a neural tube
defect that occurs during
embryonic development.

Spina Bifida

Concept map

SPINA BIFIDA

Health

PromotionCognitive/

Behavioral

Impacts

Spina Bifida
Occulta (SBO)

Spina Bifida
Cystica (SBC)

All women of childbearing age,
whether they are trying to

conceive or not, should consume
0.4mg of folic acid per day to

prevent having a child with spina
bifida; women who have

previously had a child with spina
bifida should consume 4mg of

folic acid per day

1,645 babies are born
with

spina bifida

every year in the

United States
Hispanic women

have the highest rate
of having a child with

spina bifida

Prevention

Health
MeasuresImpaired mobility and

urinary and bowel
incontinence can cause
delays in developmental
milestones, such as toilet
training; spina bifida can

also have impacts on long-
term milestones like forming

sexual relationships and
child-bearing

Complications such
as hydrocephalus,

seizures, and
infections can

cause cognitive
delays

Assessment
Findings

Lab
Studies

Imaging

Diagnosis

Environmental

Factors

Treatment

Diagnosis is based on clinical
manifestations and examination

of the meningeal sac
Neurological exams can

determine the impact on bowel
and bladder function and the
neuromuscular affect on the

lower extremities

MRIs, CTs, and ultrasounds
can be used to evaluate the

brain and spinal cord
Prenatal ultrasounds can also
be used to scan the uterus for
signs of neural tube defects

prior to birth

Amniotic fluid can be
tested during pregnancy
for indications of neural
tube defects, such as
elevated levels of α-

fetoprotein

Signs &

Symptoms

SBO is not always
apparent on inspection

and may be
asymptomatic

Possible cutaneous
manifestations include: a

skin depression or dimple,
dark tufts of hair, or port-

wine nevi

A visible, external, sac-like
protrusion on the lumbrosacral area
S/S vary based on the degree and
location of the spinal defect, and

can include:
Sensory impairment, partial

paralysis of the lower extremities,
overflow incontinence, lack of bowel
control, bladder and anal sphincter
paralysis, rectal prolapse, and

joint deformities
Demographics

Fecal continence can
often be restored with

proper nutrition (adequate
fiber intake), regular
bowel training, and

constipation prevention

50-70% of neural tube
defects could be

prevented with adequate
folic acid intake; thus, lack
of education and access
to quality, fortified foods
greatly increase the risk
of giving birth to a child

with spina bifida

Surgical closure of the sac is
recommended within the first 24 hours to
prevent complications such as infection,

rupture, and trauma to the exposed tissue
Broad-spectrum antibiotics are

initiated early for infection prevention
Physical therapy may be necessary if
there are musculoskeletal deformities

Clean intermittent catheterization,
temporary urinary diversion, or

augmentation enterocystoplasty may be
required depending on the level of

bladder dysfunction

A genetic anomaly resulting
in a fissure in the spinal

column, leaving the meninges
and spinal cord exposed.

Spina bifida is a neural tube
defect that occurs during
embryonic development.