Spina Bifida Program
The Spina Bifida Program at Children's Hospital of Pittsburgh is a comprehensive, coordinated inpatient and outpatient service for children of all ages with neural tube birth defects and spinal cord disorders. The program provides team evaluation and periodic re-evaluation utilizing the disciplines of neurosurgery, orthopedic surgery, urology, rehabilitation medicine, occupational therapy, physical therapy and social services. This coordinated, interdisciplinary team focuses on providing the best care possible to each and every patient. The team’s goal is to help each patient lead a normal life.
Urologic testing, radiology services, developmental testing, bracing assessment and full diagnostic services (i.e., CT scan, evoked potentials and MRIs) are integral components of each child’s program. Nutrition consultations are available as needed. Emphasis is placed on clear communication between the spina bifida team at Children’s Hospital and the child’s pediatrician, school, and community service agencies.
What is Spina Bifida, and How is it Treated?
The term "Spina Bifida" applies to a failure of the spinal cord and spinal column to form properly before birth. This failure can occur anywhere from the head to the tailbone, but is more common in the lumbar spine. It can occur with a wide range of severity. Spina Bifida Occulta is usually found incidentally and is often of no consequence. Myelomeningocele is a form of Spina Bifida in which the spinal cord is exposed to air at birth. Between these two extremes are other forms, each with its own characteristics.
The treatment of Spina Bifida, in principle, is to close the opening in the spine and recreate (as much as possible) the normal shape of the spinal cord and the tissues around it. The goal is to protect the spinal cord and to assure that it is not attached to the surrounding tissue. The timing of the surgery depends on the form of Spina Bifida. Myelomeningocele must be repaired soon after birth because the exposed spinal cord is susceptible to damage and infection. Other forms of Spina Bifida are repaired later, when the child is larger and older, making the surgery safer.
After the initial repair, patients need close follow-up by a coordinated team of physicians, nurses, and therapists. They may need to be treated for hydrocephalus, urologic symptoms, scoliosis, tethered cord, or muscle weakness. The exact needs of each patient depends on the type and spinal cord level of their Spina Bifida, making coordination between different members of the Spina Bifida team essential in tailoring the best treatment for each unique patient.
This is only a broad overview of Spina Bifida. If you would like more details, a good place to start is the Spina Bifida Association of America. If you would like more details about the specific needs of you or your child, talk to your doctor or call the Spina Bifida Clinic at Children’s Hospital at (412) 692-5096.
Fetal surgery for open spina bifida -- performed between 19 and 26 weeks' gestation -- is an exciting new development that we are proud to offer to appropriate candidates in conjunction with the maternal-fetal obstetricians at Magee-Womens Hospital. For more information on this treatment, please visit the Magee-Womens Hospital Fetal Diagnosis and Treatment Center or call at (412) 641-3382 or (866) 291-3382.
How Does the Spina Bifida Clinic at Children’s Hospital Work?
The Spina Bifida Clinic at Children’s Hospital sees patients on Monday afternoon. Each patient and their family are placed in an exam room, and the specialists come to see them. For the first visit, at least one member of each group (neurosurgery, orthopedics, urology, physical therapy, occupational therapy, social services, and rehabilitation medicine) will see the patients, as will the nurse noordinator, Georgia Wiltsie. Each team makes their recommendations regarding diagnostic studies and follow-up, which will be coordinated by the clinic administrators. For subsequent visits, patients see only the specialists they need.
What About Spinal Cord Injuries?
Patients with spinal cord injuries share some similarities to Spina Bifida patients, and utilize many of the same resources, so they are often seen in the clinic as well. The clinic format for these patients is the same for the Spina Bifida patients, and their needs are handled in the same coordinated manner.
How to Make an Appointment
To make an appointment, call the Spina Bifida Coordinator’s office at (412) 692-5096 or call the Children's Hospital Pediatric Neurosurgery Division at (412) 692-5090
Referrals, insurance coverage, etc. will be handled by the coordinator’s office.
For more information on the Spina Bifida Program, please visit the clinic's webpages on the Children's Hospital of Pittsburgh website.