Myelomeningocele, also known as open spina bifida, is the most severe form.^[2] Problems associated with this form include poor ability to walk, impaired bladder or bowel control, accumulation of fluid in the brain (hydrocephalus), a tethered spinal cord and latex allergy.^[2] Learning problems are relatively uncommon.^[2]

Spina bifida is believed to be due to a combination of genetic and environmental factors.^[3] After having one child with the condition, or if one of the parents has the condition, there is a 4% chance that the next child will also be affected.^[4] Not having enough folate (vitamin B₉) in the diet before and during pregnancy also plays a significant role.^[3] Other risk factors include certain antiseizure medications, obesity and poorly controlled diabetes.^[4] Diagnosis may occur either before or after a child is born.^[5] Before birth, if a blood test or amniocentesis finds a high level of alpha-fetoprotein (AFP), there is a higher risk of spina bifida.^[5] Ultrasound examination may also detect the problem. Medical imaging can confirm the diagnosis after birth.^[5] Spina bifida is a type of neural tube defect related to but distinct from other types such as anencephaly and encephalocele.^[12]

Most cases of spina bifida can be prevented if the mother gets enough folate before and during pregnancy.^[3] Adding folic acid to flour has been found to be effective for most women.^[13] Open spina bifida can be surgically closed before or after birth.^[6] A shunt may be needed in those with hydrocephalus, and a tethered spinal cord may be surgically repaired.^[6] Devices to help with movement such as crutches or wheelchairs may be useful.^[6] Urinary catheterization may also be needed.^[6]

Rates of other types of spina bifida vary significantly by country, from 0.1 to 5 per 1,000 births.^[14] On average, in developed countries, including the United States, it occurs in about 0.4 per 1,000 births.^[7][4][15] In India, it affects about 1.9 per 1,000 births.^[16] Europeans are at higher risk compared to Africans.^[17]

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