In a closed spina bifida - spina bifida occulta - there is almost always a marker on the overlying skin, usually a dimple, a naevus or a patch of hair. In spina bifida cystica, the meningeal sac plus or minus contents protrude through the defect with no skin overlying.
There is usually a flaccid weakness of muscle groups in the lower limbs, and the anus may be patulous. There is impaired sensation and there may be urinary or bowel incontinence. The precise neurological deficit is dependent on the level of the lesion.
There may also be scoliosis and club feet.
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