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Spina bifida occulta is a mild form of spinal disorder that may cause low back pain, incontinence problems, and weakness in the legs. It is common, and most people are symptom-free. Diagnosis involves imaging tests, and treatment depends on the severity of symptoms. Surgery and physical therapy are usually not necessary.
Spina bifida occulta is one of the milder forms of the common congenital spinal disorder. It usually involves a slight deformity in one or more vertebrae in the lower back that does not impede the spinal cord. In most cases, people with this condition never experience any physical symptoms or related health problems. It is possible, however, to suffer from low back pain, incontinence problems and weakness in the legs due to spina bifida occulta. Treatment decisions depend on the severity of the deformity and associated symptoms.
During embryonic development, the brain stem and spinal cord form from the remnants of the neural tube. The tube gradually closes on itself and the vertebrae come together to protect it. In the case of spina bifida occulta, the bone tissue never fully fuses to form a particular vertebra. An irregular fusion between two or more vertebrae can also occur, generally leading to more pronounced symptoms. Unlike other more severe types of spina bifida, the occult variety is not apparent at birth as normal skin, fat, and muscle tissue completely cover the deformity.
Minor forms of spina bifida occulta are very common, and about 10% of otherwise healthy people are estimated to have the condition. Most people are completely symptom free and their condition can only be recognized on routine x-rays for other health problems. Occasionally, symptoms of chronic low back pain and leg stiffness and weakness become apparent in late childhood or early adulthood. If the spinal cord or associated nerves are compressed by a spinal deformity, a person may experience numbness in the legs or feet and poor reflexes. Also, there may be a noticeable dent or dimple at the base of the back.
When evaluating a patient for lower back problems, a doctor checks for spina bifida occulta by asking about symptoms and ordering a battery of diagnostic imaging tests. X-rays, MRI scans, and computed tomography screenings are done to inspect abnormal vertebrae and make sure nerves aren’t damaged. A specialist may also collect blood and spinal fluid samples to rule out infections, cancer, and other conditions that could be causing symptoms.
If the pain is mild, the patient may simply be asked to limit physical activity and take anti-inflammatory drugs. Regular checkups are important to make sure problems don’t get worse. Surgery and physical therapy are standard treatments for other types of spina bifida, but such procedures are usually not necessary for mild spina bifida occulta.
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