Spina Bifida Occulta

Overview

What is spina bifida occulta?

Spina bifida occulta is a condition where a gap forms between the small bones (vertebrae) of your backbone (spine).

Spina bifida occulta is mild and is the most common type of spina bifida. Spina bifida is a condition present at birth (a congenital birth defect) caused by your spine forming incorrectly during fetal development.

The word “occulta” means “hidden.” Spina bifida occulta is also known as hidden spina bifida because a small layer of skin covers the opening of your spinal vertebrae.

Who does spina bifida occulta affect?

Spina bifida occulta can affect anyone. Some people are at a higher risk of having a child with spina bifida occulta if:

  • A parent has a lack of folic acid (vitamin B9) during pregnancy. Folic acid is a vitamin (B9) found in leafy vegetables, beans, whole grains and several other foods.
  • You have a history of spina bifida in your family (genetic).
  • Parents who become pregnant have conditions like diabetes or obesity.
  • Your baby has a genetic condition like Down syndrome, Edwards syndrome or Patau’s syndrome.
  • A parent is taking antiseizure medicines like valproate or carbamazepine.

If you plan on becoming pregnant, talk to your healthcare provider about the medicines you currently take or if you want to learn more about your genetic family history through a genetic test.

How common is spina bifida occulta?

Spina bifida occulta is the most common type of spina bifida and the condition affects 10% to 20% of the U.S. population.

How does spina bifida occulta affect my body?

Spina bifida occulta is mild and rarely causes symptoms that affect your body in ways that other types of spina bifida do, especially symptoms that affect movement during childhood. About 1 in 1,000 people diagnosed with spina bifida occulta will experience symptoms as their spinal cord stretches. This could happen during adolescence after a growth spurt. You might experience symptoms that affect your muscle strength, bladder and bowel control. Treatment relieves these symptoms to reduce the amount of tension in your spinal cord.

Symptoms and Causes

What are the symptoms of spina bifida occulta?

Spina bifida occulta is a mild form of spina bifida and rarely causes symptoms. Children diagnosed with spina bifida occulta might have a visible mark on their skin at the lower part of the back when they’re born that appears as a lump, a red or purple patch (hemangioma), a dark spot (birthmark) or a dimple.

Symptoms of spina bifida occulta affect the function of specific parts of your body caused by damage to your nerves (neurologic deficit), which could include:

Can spina bifida occulta become symptomatic in adulthood?

Only 1 in 1,000 people diagnosed with spina bifida experience symptoms, which normally appear as their spinal cord stretches during adolescence after a growth spurt. Most children don’t experience symptoms of spina bifida occulta. These symptoms could worsen during late adolescence and adulthood as their spinal cord stretches.

What causes spina bifida occulta?

The cause of spina bifida occulta is unknown. Research suggests that the cause could relate to several genetic, nutritional and environmental factors, including:

  • A lack of folic acid (vitamin B9) during pregnancy.
  • A history of the condition in your family (genetic).
  • A parent who has uncontrolled diabetes.
  • A parent who has obesity.
  • A reaction to medicine that treats epilepsy like valproate or carbamazepine.

Always talk to your healthcare provider if you anticipate becoming pregnant to understand your risk of having a child with a condition like spina bifida occulta. They’ll advise on whether you need to start adding folic acid to your diet or whether or not your current medications pose a threat to the health of your child.

Diagnosis and Tests

How is spina bifida occulta diagnosed?

A spina bifida diagnosis occurs prenatally during an ultrasound, but since spina bifida occulta is mild and “hidden,” many cases of spina bifida occulta go undiagnosed or receive a diagnosis later in adulthood, as there are rarely symptoms from this condition. Most often, the diagnosis of spina bifida occulta happens after an accident or injury when an X-ray of your spine is necessary.

Imaging tests, like an X-ray, MRI or CT scan, diagnose spina bifida occulta. The imaging test shows a clear picture of the bones in your spine that irregularly formed during fetal development.

Management and Treatment

How is spina bifida occulta treated?

Most cases of spina bifida occulta don’t need treatment. If symptoms occur, treatment focuses on reducing the amount of tension on your spinal cord. Treatments could include:

  • Surgery to close the gap between the vertebrae of your backbone.
  • Physical or occupational therapy to improve muscle strength.
  • Using mobility equipment like a back brace, walker or wheelchair.
  • Taking medicine to treat bladder or bowel problems.

What types of medications treat spina bifida occulta?

Medications might be necessary to treat symptoms of spina bifida occulta, including:

  • Pain medicine for back pain.
  • Laxatives, suppositories and/or enemas for bowel symptoms.
  • Antibiotics to prevent infections after surgery.
  • Medicines to relax your bladder for bladder symptoms.

Prevention

How can I reduce my risk of spina bifida occulta?

Since the cause of spina bifida occulta is unknown, you can’t prevent the condition. If you plan to become pregnant, you can take steps to reduce your risk of having a child with spina bifida occulta by:

  • Taking folic acid: The U.S. Centers for Disease Control and Prevention (CDC) recommends taking 400 micrograms (mcg) of folic acid daily. This could reduce your risk of having a child with spina bifida by up to 75%.
  • Talking to your healthcare provider: Discuss the medications you currently take, along with any vitamins or supplements. Certain medicines, especially medicine to treat epilepsy, can cause spina bifida occulta.
  • Managing underlying conditions: If you have preexisting diagnoses of diabetes or obesity, work with your healthcare provider to manage the condition before becoming pregnant.
  • Getting a genetic test: If you have a history of genetic conditions in your family, talk to your healthcare provider about genetic testing to understand your risk of having a child with a genetic condition.

Outlook / Prognosis

What can I expect if I have spina bifida occulta?

There isn’t a cure for spina bifida occulta. If you have this condition, you might not know you have it, as symptoms are rare and mild. Every case of spina bifida occulta affects each person differently. Treatment can ease symptoms if you do experience discomfort caused by your spinal cord stretching.

Living With

How do I take care of myself?

Each diagnosis of spina bifida occulta is unique. Most cases won’t impact your day-to-day ability to thrive. Follow your healthcare provider’s treatment plan to alleviate your symptoms if you do experience them.

When should I see my healthcare provider?

Visit your healthcare provider if you experience symptoms of spina bifida occulta, especially if your symptoms affect your movement. If symptoms prevent you from completing your daily routine or prevent you from going to school or work due to pain, or affect your inability to control your bowels, visit your healthcare provider for treatment.

What questions should I ask my doctor?

  • Am I at risk of having another child diagnosed with spina bifida occulta?
  • How can I stay healthy during my pregnancy?
  • What are the risks of surgery to treat spina bifida occulta?
  • Are there side effects to the treatment you recommended?

Frequently Asked Questions

What is the difference between spina bifida occulta and spina bifida cystica?

Spina bifida occulta is a mild form and the most common type of spina bifida. Most people diagnosed with spina bifida occulta won’t experience visible symptoms or symptoms that affect their movement.

Spina bifida cystica is a more severe form of spina bifida that causes a visible cyst (fluid-filled sac) on the lower part of your baby’s back. This cyst is a symptom of spina bifida meningocele and myelomeningocele.

Children born with spina bifida occulta don’t have a cyst on their spine as a result of the gap that forms between vertebrae bones.

A note from Cleveland Clinic

Most cases of spina bifida occulta go undiagnosed, or receive a diagnosis but don’t need treatment, as there are rarely symptoms. Before becoming pregnant, talk with your healthcare provider to make sure you’re getting enough vitamins and nutrients to prevent conditions like spina bifida from affecting your developing baby. If you have a history of spina bifida in your family and want to understand your risk of having a child with the same condition, talk to your healthcare provider about genetic testing.

Last reviewed by a Cleveland Clinic medical professional on 04/17/2022.

References

  • American Association of Neurological Surgeons. Spina Bifida. (https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spina-Bifida) Accessed 4/17/2022.
  • Centers for Disease Control and Prevention. What is Spina Bifida? (https://www.cdc.gov/ncbddd/spinabifida/facts.html) Accessed 4/17/2022.
  • National Health Services. Spina Bifida. (https://www.nhs.uk/conditions/spina-bifida/) Accessed 4/17/2022.
  • Spina Bifida Association. Spina Bifida Occulta. (https://www.spinabifidaassociation.org/resource/occulta/) Accessed 4/17/2022.
  • U.S. Department of Health & Human Services. Spina Bifida Fact Sheet. (https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Spina-Bifida-Fact-Sheet) Accessed 4/17/2022.

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