Spina bifida is Latin for “split spine” and refers to a developmental abnormality in closure of an embryo’s neural tube (that portion of the fetus destine to develop into the central nervous system (CNS)).  Tethered spinal cord refers to a collection of developmental malformations (tight filum terminale, lipomeyelomeningcele, diastematomyelia, dermal sinus tract, dermoid, cystocele) or abnormalities associated with surgery in the spinal cord that result in the spinal cord’s being attached to surrounding tissue and functioning abnormally because of this.  There are three forms of spina bifida.  They are, in order of increasing severity of maldevelopment, spina bifida occulta (simple defect in posterior bony spine with a normal spinal cord), spina bifida cystica with meningocele (posterior defect in bony spine and in dura that surrounds the nerves and spinal cord with normal development of the spinal cord) and spina bifida cystica with a myelomeningocele (posterior defect in spine and dura associated with an incomplete close and maldevelopment of the spinal cord). In common usage spina bifida typically refers to spina bifida cystica with a myelomeningocele.  Both spina bifida and tethered spinal cord can result in abnormal development and function in the spine, legs, bowel and bladder.

The specialists at Function have an expertise in the treatments for the conditions seen in children and adults with spina bifida and other forms of tethered spinal cords.  After an evaluation they can devise an coordinated treatment plan that draws on their knowledge and abilities.  Treatments considered include: 

• Physical and occupational therapy
• Oral medications
• Orthotics and assistive devices
• Nerve injections (BOTOX, Pheol, Alcohol)
• Detethering and other spinal cord operations
• Hydrocephalus operations
• Chiari malformation operations
• Spasticity operations
• Joint reconstruction and joint fusion
• Osteotomies
• Femoral head resection)
• Urological assessment (ultrasonic evaluation voiding, uroflowetry, cystometry, EMG studies, cystoscopy, vaginoscopy)
• Appendicovesicostomy surgery
• Bladder augmentation surgery
• Bladder neck repair
• Enteroenterostomy surgery
• Sling surgery
• Cystourethroplasty surgery