From the Guidelines
Spina bifida occulta typically requires no specific treatment as it's the mildest form of spina bifida and usually causes no symptoms. Most people with this condition are unaware they have it until it's discovered incidentally on imaging studies. For the small percentage who develop symptoms, management focuses on addressing specific issues that arise. If back pain occurs, conservative treatments including physical therapy, non-steroidal anti-inflammatory medications (like ibuprofen 400-800mg every 6-8 hours or naproxen 250-500mg twice daily), and core strengthening exercises are recommended 1. In rare cases where neurological symptoms develop, such as bladder or bowel dysfunction, referral to a neurosurgeon may be necessary to evaluate for tethered cord syndrome or other complications.
Children with spina bifida occulta should be monitored during growth periods for the development of scoliosis or other spinal abnormalities. Preventive measures include:
- Maintaining good posture
- Regular exercise
- Healthy weight management to reduce stress on the spine. Unlike more severe forms of spina bifida, occulta doesn't typically require surgical intervention, specialized equipment, or extensive multidisciplinary care, as noted in studies on urological management 1. The benign nature of this condition stems from the fact that the spinal cord and nerves remain intact and protected, with only a minor defect in the vertebral arch that doesn't affect neurological function in most cases.
From the Research
Spina Bifida Occulta Management
- Spina bifida occulta is a type of neural tube defect that can be challenging to manage due to its complex nature and varying degrees of severity 2.
- The management of spina bifida occulta involves a comprehensive approach, including neurologic, urologic, musculoskeletal, skin, and habilitation management 3.
- Orthopedic problems are common in individuals with spina bifida, and treatment guidelines have been developed to address these issues, including evaluation and treatment guidelines for specific age ranges 4.
- Surgical management of spina bifida occulta, including spinal lipoma and tethered spinal cord, has evolved over time, with advances in techniques such as intraoperative neurophysiological mapping and monitoring 5.
Diagnosis and Treatment
- Diagnosis of spina bifida occulta can be made using radiographs, but it is not a reliable indicator of underlying spinal cord abnormalities 6.
- Magnetic resonance imaging (MRI) is a more accurate tool for detecting spinal cord abnormalities, and it is recommended for patients with suspected spinal cord dysfunction 6.
- Treatment of spina bifida occulta depends on the severity of the condition and the presence of any associated spinal cord abnormalities, and may include surgical intervention, physical therapy, and other supportive measures 2, 5.
Current Research and Guidelines
- Current research suggests that spina bifida occulta is not a predictor of underlying spinal cord abnormality in patients with lower urinary tract dysfunction 6.
- Guidelines for the management of spina bifida occulta have been developed, including orthopedic guidelines for the care of people with spina bifida 4.
- Further research is needed to improve our understanding of spina bifida occulta and to develop more effective treatment strategies 2, 5.