This disorder is a very mild form of the far more serious spina bifida. Occulta literally means “not seen” – and for most people who have spina bifida occulta, there are no symptoms, and their lives are not affected in any way. Many people may have the problem, but remain unaware of it their whole lives. In general, when people are diagnosed with the disorder, it is through x-rays taken of the lower spine for quite separate reasons.
It is estimated that between 5-10 % of the population may have spina bifida occulta. Of that group, around 2 % may suffer problems due to the disorder.
The physical disorder that is spina bifida occulta is simply an incomplete vertebra. The spinous process (these are the bumps you feel along your spine) is missing or incomplete in one vertebra low in the back. Occasionally two or more vertebrae can be incomplete. The spinal meninges is complete, and the disorder usually has no effect on the person’s health. There are various aspects of physical appearance that may indicate spina bifida occulta, including a dimple or sinus, birthmark or patch of hair positioned over the lower area of the spine. There can even be a rudimentary tail.
When spina bifida occulta causes complications and health problems, they can occur in a range of different forms. Spina bifida occulta with such complications is often known as occult spinal dysraphism. Problems which can occur include:
- Tethered spinal cord (spinal cord unable to move freely in spine, tethered in one spot by nerves).
- Distortion of the spinal cord
- Fatty tumours in the spine, under the skin or in surrounding tissues
- Cysts in the spine, under the skin or in the skin
- Divisions in the spinal cord
These abnormalities can cause physical problems such as the following:
Some of the effects of spina bifida occulta can be alleviated through various methods. There is an operation which will “de-tether” the spinal cord, though this has a 2 – 5 % chance of failure, and will not often improve bladder function, however is likely to prevent any further deterioration of leg muscle and bladder function. Continence problems can be alleviated through various physiotherapeutic methods. Operations can also be carried out to improve leg and foot function and to remove cysts etc in the spine.
Spina bifida occulta is not well understood. Many doctors do not believe in it, many more do not believe that it ever causes physical problems. If you suspect that you or someone you know may suffer from the disorder – choose your physician with care. It’s not nice for an 11 year old kid to be told that he’s putting it all on to get attention when he’s got some of the less socially acceptable problems associated with spina bifida occulta.
Even those neurologists, urologists etc who understand the problem are faced with a lack of real research into the cause of the disorder. It appears to be caused by a combination of environmental and genetic factors – there is evidence to suggest that sufficient folic acid in the mother’s diet can reduce the risk of a child being born with the syndrome. People with a close family history of neural tube defects need a higher level of folic acid – a level that cannot be obtained simply from eating foods high in folate.
People who suspect they have spina bifida occulta should consult their general physician, and be referred to a neurologist.