The spine and spinal cord essentially form as a flat plate during gestation, then fold over into a tube before birth. This process starts at the top of the spine and proceeds down towards the base of the spine, like a zipper closing. Spina bifida refers to any interruption of this process, and is more common in the lower areas of the spine.
The most severe form is a myelomeningocele, where portions of the nerves and possibly spinal cord are outside of the body. The most minor form is spina bifida occulta
, where the only finding is a failure of the lower sacral bones to form a tube. This is typically found on an x-ray of the spine, and often is asymptomatic
However, even spina bifida occulta can cause pain. In a patient with spina bifida with pain, the next step is often an MRI
to look at the nerves of the back to see if there are any associated problems. It is possible to have an assocated tethered cord
, lipomeningocele, etc... (all other abnormalities of the base of the spine and spinal cord).
Depending on where your pains are, what other complaints you may have, what your examination and imaging
shows, there may be some treatments possible to help.