Spina bifida occulta first develops when a baby is growing in its mother’s womb. The condition affects the spine, which fails to form correctly. In people with spina bifida occulta, some of the vertebrae, or bones of the spine, are unable to close fully.
Spina bifida occulta may leave those with the condition susceptible to symptoms caused by their spinal column being left exposed.
According to the Spina Bifida Association, 10 to 20 percent of people have spina bifida occulta. However, many do not realize they have it, as it is possible not to experience symptoms. Another name for this is hidden spina bifida.
Fast facts on spina bifida occulta:
- A person with spina bifida occulta will often experience no symptoms.
- In cases where symptoms are noticeable, they are usually extremely mild.
- Spina bifida occulta has no known cure.
The name spina bifida occulta comes from the Latin words “spina,” meaning spine, “bifida,” meaning split, and “occulta,” meaning hidden or secret.
People with spina bifida occulta may have very mild symptoms or none at all.
Therefore, the condition is usually discovered accidentally via an X-ray or MRI scan that a person has for another reason.
Differences to open spina bifida
Open spina bifida, which is also known as myelomeningocele, is a severe congenital disability.
Those with open spina bifida are likely to have mobility issues, and experience injury and infection more frequently than people with spina bifida occulta.
A person with open spina bifida has a spinal canal that is open to varying degrees all the way along its length. Also, a sac that contains part of the spinal cord pushes out through the skin.
Symptoms of spina bifida occulta are usually mild, the gaps in the vertebrae are minimal and the spinal cord is still well protected.
However, some people with spina bifida occulta report having some symptoms. These can include:
- back pain
- weakness in the legs
- numbness or pain in the back of the legs
- curvature of the spine, known as scoliosis
- lack of bladder or bowel control
- misshapen legs and feet
Approximately 1 in 1,000 people with spina bifida occulta will experience symptoms such as these.
In some cases, people can see signs of their spinal cord abnormality, as this can cause changes in the skin along the midline of the lower back. Visible signs of a possible spinal cord abnormality include:
- a hairy patch on the skin
- discoloring of the skin or a birthmark
- a dimple or indented patch of skin
- a growth or pad of fat
If a person notices these signs, they should see their doctor to talk about their concerns.
Tethered cord syndrome is the most common complication of spina bifida occulta.
A person’s spinal cord runs from their brain down their spinal column. When tethered cord syndrome occurs, the usually free-hanging spinal cord becomes attached to the spinal column, restricting its movement.
Children with tethered cord syndrome can experience nerve damage and neurological problems because the fixed cord must stretch as they grow.
The symptoms include:
- back pain
- weakness in both the legs and arms
- difficulty controlling the bladder and bowel
There is no cure for spina bifida occulta, but treatment is unnecessary for most people as they have no symptoms.
When symptoms do occur, they are treated individually. If a person suffers from back pain, for example, they could receive physiotherapy or pain medication to help manage this. If tethered cord syndrome occurs due to spina bifida occulta, it may be possible to have simple surgery to free the cord.
Even though surgery is usually successful, the cord can re-tether and, therefore, the surgery may need to be repeated several times.
Researchers are not certain why one person and not another might have spina bifida occulta. However, spinal cord defects are more likely to occur in babies whose mothers do not have a sufficient intake of folic acid while pregnant.
Pregnant women are advised to take a folic acid supplement, during pregnancy, to boost their intake.
The Centers for Disease Control and Prevention (CDC)and the United States Public Health Service (PHS) advise that all women who can become pregnant ensure they consume 400 micrograms (mcg) of folic acid daily, even before conception occurs.
Women with diabetes and those who have previously given birth to a child with a neural tube defect are at a higher risk.
Ensuring the proper intake of folic acid supplementation during pregnancy can reduce the risk of spinal defects, such as spina bifida, by 40 to 100 percent.
People can try to boost their folic acid intake by eating more of the foods that contain it, including dark leafy vegetables and fortified cereals. Alternatively, supplements can be taken orally in pill or capsule form.
Spina bifida occulta is often only discovered when a person with the condition visits their doctor for an unrelated reason.
If a doctor does specific tests or examinations and notices the signs of spina bifida occulta, they may do follow up tests.
These may include an X-ray or MRI scan to confirm that the condition is present.
Is spina bifida occulta a disability?
Having spina bifida occulta does not mean a person has a disability. However, it may be that someone who suffers severe symptoms because of the condition will be entitled to benefits due to restrictions or limitations they may experience.
Spina bifida occulta is a common condition. Many people live their whole lives without realizing they have it because symptoms are often mild or unnoticeable.
Spina bifida occulta can occur without prior family history, and those who have it are not likely to pass it on if they have children.
Complications of spina bifida occulta, such as tethered cord syndrome, may require surgery. Other symptoms are usually successfully managed through pain relief medication and physical therapy if they occur.