Spina Bifida Clinic

Dartmouth-Hitchcock's Spina Bifida Clinic provides care for children and young adults up to age 22.

Our goal is to keep our patients in the best possible health and foster their independence. We are also an information resource for patients, families, and professionals in the community.

Our multidisciplinary team includes:

  • A pediatric neurosurgeon and a pediatric neurosurgical nurse practitioner
  • A pediatric urologist and a pediatric urology nurse practitioner
  • A pediatric orthopedic surgeon
  • A pediatric physiatrist
  • A pediatrician who specializes in spina bifida care
  • A nurse practitioner who specializes in spina bifida care
  • A nurse coordinator

About spina bifida

Spina bifida means "split" or "open" spine.

Spina bifida occurs when spinal bones don't close properly when they are formed. When this happens, messages from the brain have difficulty passing to various parts of the body. This can affect several areas of the body:

  • Central nervous system: Nine of out ten children develop hydrocephalus, which is the excessive increase of fluid within the ventricles of the brain. In 80 to 90 percent of babies born with hydrocephalus, a shunt must be placed to drain fluid from the ventricles to the abdominal cavity. This surgery may be done at birth when the lesion in the baby's back is repaired, or may be done later as needed.
  • Urologic system: Bowel and bladder dysfunction (called neurogenic bowel and bladder), is caused when the brain is unable to deliver messages to organs along the damaged spinal cord. Often, those with spina bifida are unable to feel when their bladder is full, and cannot empty their bladders as needed, or may be incontinent. In this case, their bladder function can be managed by using a catheter. Someone with a neurogenic bowel is unable to feel the need or control the movement of their bowels. These issues can be managed in a variety of ways, including a high fiber diet, plenty of fluids, and medication.
  • Musculoskeletal system: The musculoskeletal system and bone and joint function may develop at different levels in a person with spina bifida. Abilities range from being able to walk independently without the use of any device, to needing to use waist-high braces, a walker, or crutches. It is usually assumed that the lower the level of a lesion a child is born with, the greater their walking potential will be.

The amount that these systems are affected depends on the type, level, and severity of the condition.

Individuals with spina bifida are also at greater risk of developing an allergy to latex, a natural rubber found in hundreds of products surrounding us every day like rubber gloves, balloons, and even the elastics on underwear or socks. Allergic reactions can range anywhere from itchy eyes to a possible anaphylactic reaction. To help with this potential allergy, persons with spina bifida can use alternative products to latex like vinyl, plastic, or silicone.

The role of folic acid

Taking folic acid as a supplement before and during early pregnancy can help prevent birth defects, including spina bifida. The following resources have more information about folic acid: