An open spinal defect may cause weakness in the infant’s lower extremities and/or bowel/bladder function due to the exposed neural tissue during in utero development. The higher the lesion on the baby’s back the more likely the infant will demonstrate weakness in their neurological/urological/orthopedic functioning. Patients with open spina bifida are managed by a multidisciplinary team of specialists to define a newborn’s function and monitor for any decline throughout childhood. This team consists of: pediatric neurosurgeons, pediatric urologists, pediatric orthopedic surgeons, physical medicine and rehabilitation specialists, nursing, social work, developmental pediatricians, and pediatric therapists.
During in utero development, open spina bifida allows escape of spinal fluid where the spinal cord is exposed. This egress of spinal fluid may lead to abnormalities in the development of the brain and spinal cord, known as the Chiari II malformation. All babies with open spina bifida have a Chiari II malformation, but not all children demonstrate symptoms related to this condition.
Many infants born with open spina bifida will have an enlargement in the spinal fluid cavities of the brain, known as the cerebral ventricles. Some children with myelomeningocele may develop progressive enlargement of the ventricles requiring either diversion of the fluid (known as a ventriculo-peritoneal shunt) or creation of an alternate brain pathway (known as an endoscopic third ventriculostomy, or ETV) for adequate fluid management. A pediatric neurosurgeon will monitor the infant with open spina bifida for progressive enlargement of the ventricles, or hydrocephalus.