Many adults receive a diagnosis of Spina Bifida Occulta, a mild form of Spina Bifida. However, the scarcity of information, resources, and awareness often leads to frustration.
What is Spina Bifida Occulta?
Spina bifida Occulta (SBO), is the mildest and most common form of SB. People often call it “hidden Spina Bifida” because about 15 per cent of healthy individuals have it without knowing. SBO usually does not cause harm and has no visible signs. The spinal cord and nerves are usually normal and remain in the spine, unlike the other types of SB.
Imaging tests for other conditions often incidentally discover SBO. These imaging tests show a gap forming between the vertebrae in your spinal cord. X-ray and MRI studies of the spine will reveal a much higher percentage of children with SBO. In many cases, especially in children, this gap can close, over time as they grow.
SBO itself is not a cause of back pain. Typically, doctors do not recommend treatment unless symptoms develop. However, in a small group of people with SBO, pain, skin, and structural and neurological symptoms as described below may occur.
What are the potential indicators that Spina Bifida Occulta might cause issues?
In individuals with Spina Bifida Occulta, the following signs may suggest a serious neurological issue like a Tethered Spinal Cord, where the spinal cord becomes stretched:
- Radiating and thrombing pain into one or both legs, and at times, in the hips.
- Muscle weakness in one or both legs.
- Numbness or other changes while feeling the legs, hips and back.
- Balance difficulties.
- Bladder and Bowel Dysfunction Changes in bowel or bladder function.
- Scoliosis.
- Foot deformities like abnormalities of foot alignment (such as the foot being turned more inward than usual).
Anyone experiencing these concerns should promptly consult a Neurologist. Neurological evaluations may involve Magnetic Resonance Imaging (MRI) or, for newborns, a spinal ultrasound.
There are some forms of Spina Bifida Occulta that do cause problems. They are:
- Lipomyelomeningocele and Lipomeningocele – the spinal cord is attached, or tethered, to fat under the skin.
- Thickened, fatty filum – the filum, a string which we all have that runs from the bottom of the cord to the tail bone, is either too thick and/or infiltrated with fat. Either a thickened and/or fatty filum may be tethering to the spinal cord.
- Diastematomyelia (split spinal cord) and Diplomyelia – the spinal cord splits into two hemicords around either a fibrous or bony spur. The cord or hemicords end in a fatty mass or filum, which may also be tethered to the cord.
- Dermal Sinus Tract – when a band of tissue connects the spinal canal/cord and the skin of the back. This tract is not only tethering to the spinal cord but may also be a portal of entry for bacteria into the nervous system.
What about people with no leg pain or any neurologic problem?
Although not specific to SBO, other clues to a possible spinal cord problem include skin abnormalities in the low back, such as the following:
- A hairy patch.
- A fatty lump.
- A Red or purple spot, which might be a haemangioma, a benign growth of blood vessels.
- A dark spot or birthmark. The blue-black marks called “Mongolian spots” are not a risk factor for SBO or neurologic problems.
- A deep hole or tunnel in the skin, especially above the top of the buttocks crease. This is a skin tract or sinus. It can look like a deep dimple.
- An area of less skin colour, called a hypopigmented spot.
If you have any skin condition, see a Dermatologist for an evaluation.
Low Back Pain and SBO
Low back pain is a very common issue. Spina Bifida Occulta (SBO) does not seem to cause low back pain, and many people with low back pain for other reasons may also have SBO identified on X-rays. The treatment for low back pain is the same for those with or without SBO, and SBO itself does not require specific treatment. People generally manage low back pain with activity, exercise, topical heat, and over-the-counter medications. Excessive rest harms you in the long run. Lower impact activities like walking, swimming, yoga, or biking can be beneficial. For severe or persistent pain, physical therapy may be appropriate. Physical therapists can help develop a suitable exercise plan and educate patients on how to minimize or prevent further episodes of pain.
If back pain is accompanied by radiating pain into the legs (sciatica), numbness, tingling, or weakness in the legs, balance difficulties, changes in bladder or bowel function, or other similar issues, it’s advisable to seek an initial medical evaluation from a Neurologist.
Physiatrists and Pain Management Doctors specialize in non-surgical care for pain and joint issues, making them excellent resources for managing back pain, Spina Bifida Occulta (SBO), or other spine-related concerns. For surgical considerations related to back pain and spinal disorders, consulting spine surgeons (either orthopedic surgeons or neurosurgeons) is advisable. They can also guide non-surgical treatments for spine issues like back pain and SBO. Neurologists typically handle neurological concerns such as weakness or numbness, if these symptoms are present.
Please Note
The information provided on our website is not intended as medical advice for any individual. Since specific cases may differ from the general information presented, SASHA recommends consulting a qualified medical or other professional for personalized advice.
About the author
Raul/DJ Vivek
Meet Vivek Bharadwaj, a remarkable individual who has defied the odds and soared to new heights despite living with Spina bifida. As the founder of the Sasha Foundation, Vivek tirelessly advocates for others facing similar challenges. His unwavering commitment to support, awareness, and empowerment had made a lasting impact on the Spina bifida community.
