Spina bifida is a birth defect in which the spinal column does not close fully. In its most serious form, myelomeningocele, the spinal cord and nerves lie exposed in a sac on the baby's back. Surgery closes the defect in layers to protect the cord and prevent infection. Related operations include shunting for hydrocephalus and release of a tethered spinal cord later in childhood.
Closure prevents meningitis and further nerve damage. It cannot restore nerve function already lost, so leg weakness and bladder and bowel problems usually persist to a degree set by the level of the defect, and lifelong multidisciplinary care is needed.
What Spina Bifida Surgery involves
Postnatal closure is done within 24 to 72 hours of birth. Under general anaesthesia the baby lies face down. The neurosurgeon, working with magnification, separates the flat plate of exposed neural tissue from the surrounding skin, rolls it into a tube and returns it to the spinal canal. The dura is freed and stitched closed to make a watertight covering, then muscle and fascia are brought together over it and the skin is closed, with a plastic surgeon rotating skin flaps if the defect is wide. Head size and ultrasound are monitored afterwards, and a shunt or endoscopic third ventriculostomy is performed if hydrocephalus develops.
Who is a good candidate for Spina Bifida Surgery?
Decisions are made by a fetal medicine, neonatal and paediatric neurosurgical team, usually after prenatal diagnosis on ultrasound.
- Newborns with open myelomeningocele, who need closure in the first days of life
- Selected pregnancies between about 19 and 26 weeks that meet strict criteria for fetal repair
- Children with closed spinal dysraphism such as lipomyelomeningocele and worsening symptoms
- Children or adults with spina bifida whose leg function, bladder control, pain or scoliosis is deteriorating from a tethered cord
It is usually not the right choice if:
- Spina bifida occulta found by chance on an X-ray with no symptoms, which needs no treatment
- Fetal repair when the mother has a high body mass index, previous uterine surgery, a short cervix or placental problems, or when the fetus has other major anomalies
- Tethered cord seen on MRI without any clinical change, which is usually monitored
- A newborn who is medically unstable, until stabilised
Technique options
- Postnatal closure: The standard of care worldwide, within 72 hours of birth.
- Open fetal surgery: The uterus is opened during pregnancy and the defect closed. A major trial showed less need for shunting and better walking, at the cost of premature birth and risks to the mother.
- Fetoscopic repair: Keyhole repair in the womb, offered at a small number of centres; still evolving.
- Ventriculoperitoneal shunt or endoscopic third ventriculostomy: Treats hydrocephalus, needed in most children after postnatal closure.
- Tethered cord release: Microsurgical freeing of the cord from scar tissue when symptoms progress.
What happens during your treatment
Postnatal closure takes 2 to 4 hours under general anaesthesia, and the baby is then nursed face down or on the side in the neonatal intensive care unit. Fetal surgery takes about 3 hours under general anaesthesia for the mother, who then stays in hospital for around a week and delivers by caesarean section, typically at 34 to 37 weeks.
Preparing for your trip
Plan for 2 to 3 weeks for planned tethered cord surgery in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.
- Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
- Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
- Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
- Book a changeable return flight; your surgeon confirms when you are fit to fly
Recovery and results
After closure, babies usually stay in hospital for 2 to 4 weeks while the wound heals, feeding is established and hydrocephalus is watched for. Clean intermittent catheterisation is often started early to protect the kidneys. After tethered cord release, children lie flat for 1 to 3 days and go home in under a week. Follow-up with neurosurgery, urology, orthopaedics and physiotherapy continues through life.
- Back to everyday activity: 4 to 6 weeks of restricted activity in older children
- When results show: Defect closed immediately; function is monitored for years
- How long they last: Closure is permanent; lifelong follow-up needed
Safety, risks and revision policy
Risks relate both to the operation and to the condition itself.
- Spinal fluid leak or wound breakdown, particularly with large defects
- Meningitis or shunt infection
- Hydrocephalus needing a shunt, and later shunt blockage requiring revision
- Symptoms from Chiari II malformation such as breathing or swallowing difficulty
- Re-tethering of the cord with later deterioration, in about 10 to 30 percent
- Worsening of leg or bladder function after tethered cord release, which is uncommon
- For fetal surgery: premature birth, membrane rupture, and uterine scar problems in this and future pregnancies
Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.
Cost of Spina Bifida Surgery in Türkiye
Clinic-Y does not publish a single price for Spina Bifida Surgery, because the honest figure depends on your case. What moves it:
- Prenatal, neonatal or later childhood surgery
- Length of neonatal intensive care
- Shunt or endoscopic hydrocephalus procedures
- Plastic surgical closure for large defects
- Urodynamics, MRI and rehabilitation during the stay
Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.
Frequently Asked Questions
Can we travel abroad for our newborn's closure?
No. A baby with an open defect should be operated on where they are born, within 2 to 3 days. If you want delivery and surgery in a particular centre, you must move there well before the due date and plan the birth with that team.
What can realistically be done on a planned visit?
A second opinion on MRI and urodynamics, tethered cord release, shunt assessment, or orthopaedic and urological procedures for an older child.
Will my child walk?
It depends mainly on the level of the defect. Children with low lumbar or sacral lesions usually walk, often with braces; higher lesions often mean wheelchair use.
Does folic acid prevent it?
Taking folic acid before conception and in early pregnancy prevents most, but not all, cases. Women with a previous affected pregnancy need a higher prescribed dose.