Spina Bifida

Plain-language definition

Congenital spinal column malformation. Essential physiotherapy follow-up from birth and throughout life.

Signs and points requiring attention

• Lower limb paralysis: of variable severity depending on the level of involvement (the higher the lesion, the greater the deficit). Can range from mild weakness to complete paraplegia.
• Sensory disorders: areas of anesthesia below the lesion level exposing to risk of pressure sores, burns and unnoticed injuries. Rigorous skin monitoring essential.
• Bladder and bowel disorders: urinary and fecal incontinence or retention, often requiring intermittent catheterization and regular urological follow-up. Risk of urinary infections and kidney damage.
• Frequent orthopedic deformities: clubfoot, hip dislocation, scoliosis, requiring early orthopedic monitoring and treatment. Growth amplifies untreated deformities.

• Appearance of new weakness or worsening: may signal tethered cord, syringomyelia, or decompensated hydrocephalus. Urgent neurosurgical consultation.
• Persistent skin redness or wound: risk of pressure sore that can worsen rapidly on insensitive skin. Immediate pressure relief, local care, medical advice if no improvement in 24-48h.
• Fever with lower back pain or cloudy urine: suggests upper urinary tract infection (pyelonephritis), a common complication. Medical consultation and urgent antibiotic treatment to protect kidneys.

Assessment and care

• Early motor rehabilitation: motor development stimulation, acquisition of rolling, sitting, all-fours, standing, with or without bracing depending on level of involvement.
• Deformity prevention and treatment: stretching, posturing, bracing (splints, corset), in coordination with orthopedist. Goal: limit contractures and maintain joint range.
• Gait rehabilitation adapted to potential: depending on neurological level, gait work with long-leg braces, walker, canes, or optimization of wheelchair use.
• Strengthening of functional muscles: maximizing capabilities of muscles above the lesion, upper limb work, core strengthening, for independence in transfers and wheelchair propulsion.

This information does not replace diagnosis or medical consultation.