What is Spina Bifida Occulta?

D. Jeffress

Spina bifida occulta is one of the mildest forms of the common congenital spine disorder. It usually involves a slight deformity in one or more vertebra in the lower back that does not impede on the spinal cord. In most cases, people with the condition never experience physical symptoms or related health problems. It is possible, however, to suffer from lower back pain, incontinence issues, and leg weakness due to spina bifida occulta. Treatment decisions depend on the severity of the deformity and the associated symptoms.

Lower back pain is a somewhat rare symptom that can indicate spina bifida occulta.
Lower back pain is a somewhat rare symptom that can indicate spina bifida occulta.

During embryonic development, the brain stem and spinal cord form from the remnants of the neural tube. The tube gradually closes in on itself and vertebrae come together to protect it. In the case of spina bifida occulta, bone tissue never fully fuses together to form a particular vertebra. Irregular fusing between two or more vertebrae can also occur, which generally leads to more pronounced symptoms. Unlike other more serious types of spina bifida, the occulta variety is not obvious at birth since normal skin, fat, and muscle tissue completely cover the deformity.

Spinal bifida occulta can lead to poor reflexes.
Spinal bifida occulta can lead to poor reflexes.

Minor forms of spina bifida occulta are very common, and it is estimated that about 10 percent of otherwise healthy people have the condition. Most people are entirely symptom-free, and their conditions may only be recognized during routine x-rays for other health issues. Occasionally, symptoms of chronic lower back pain, stiffness, and leg weakness become prominent in late childhood or early adulthood. If the spinal cord or associated nerves are compressed by a spine deformity, a person may experience numbness in the legs or feet and poor reflexes. In addition, there may be a noticeable dent or dimple at the base of the back.

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When evaluating a patient with lower back problems, a doctor checks for spina bifida occulta by asking about symptoms and ordering a series of diagnostic imaging tests. X-rays, magnetic resonance imaging scans, and computerized tomography screenings are performed to inspect the abnormal vertebrae and make sure that nerves are not damaged. A specialist may also collect blood and spinal fluid samples to rule out infections, cancer, and other conditions that might be causing symptoms.

If pain is mild, a patient may simply be instructed to limit physical activity and take anti-inflammatory medications. Regular checkups are important to make sure that problems do not worsen. Surgery and physical therapy are standard treatments for other types of spina bifida, but such procedures are usually unnecessary for mild spina bifida occulta.

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