Our grandbaby was born with spina bifida. I read about it on-line. What I can’t understand is why this problem is supposedly better than having myelomeningocele. Aren’t these two problems the same thing?

This type of defect is called a neural tube disorder. The neural tube is the protective sheath of bone and meninges that encase the entire spinal cord. It is formed early in utero (around the 19th day in the womb). There are three major types of neural tube defects.

The most common neural tube defect is called spina bifida or spina bifida occulta. Occulta means hidden. Without an X-ray the defect is unseen. In this condition, there is an incomplete closure (incomplete fusion) of the arch of bone around the spinal cord.

Meningocele is more severe than spina bifida. There is a failure of the bone to close around the spinal cord (like in spina bifida), but there is also a protrusion of the meninges outside the spinal column. Meninges is the covering around the spinal cord. In meningocele, the vertebral arch doesn’t fuse. And the meninges covering the spinal cord expand out because the missing bone doesn’t contain them.

With myelomeningocele, there is spina bifida, meningocele, and a failure of the meninges to cover and protect the spinal cord. The vertebral arch and meninges fail to close when the child is developing in the womb. Both the meninges and the spinal cord are protruding.

Generally these defects occur in the lumbosacral (low back) area. But they may also be found in the sacral, thoracic, and cervical areas. The clinical picture is different depending on the severity and location of the problem. For example, children with myelomeningocele are more likely to have foot and ankle deformities or bowel and bladder problems than children with spina bifida occulta. Myelomeningocele can also be accompanied by hip dislocation, scoliosis, changes in muscle tone, and cognitive impairment.