Learn about the most common and severe form of spina bifida, myelomeningocele (MMC), and the long-term complications. http://www.chop.edu/spinabifida In this video, N. Scott Adzick, MD, along with other members from the Center for Fetal Diagnosis and Treatment at Children’s Hospital of Philadelphia, describe spina bifida and its most severe form, myelomeningocele (MMC), as well as the complications it causes for the newborn. Spina bifida begins early in pregnancy when the spinal cord fails to close properly. The skin does not close around the spinal column, or neural tube, leaving the elements of the spinal cord exposed to the amniotic fluid. Movement and prolonged exposure to amniotic fluid cause progressive damage to the exposed spinal cord. Another key spina bifida fact is that it can cause brain damage: Leakage of cerebrospinal fluid from the opening in the spine can cause the lower portion of the brain to be drawn down into the spinal column (hindbrain herniation). This, in turn, can block circulation of cerebrospinal fluid and cause fluid buildup around the brain (hydrocephalus). After birth, ongoing complications of spina bifida can include paralysis, club feet, bowel and bladder problems, breathing problems, curved spine, tethered cord, and a variety of other issues that affect quality of life. To minimize the damage caused by increased fluid buildup on the brain, a shunt tube can be placed by a pediatric neurosurgeon. However, shunts come with risk of complications and infections.