Perioperative management of patients with spina bifida

Spina bifida (SB) is a congenital neural tube defect (NTD) that results from incomplete spinal column closure during em- bryonic development. Neural tube defects are among the commonest birth defects. The incidence of SB is six in every 10,000 births (0.06%) in the UK. 1 This has declined with folic acid supplementation and varies significantly across different populations. 2,3 Ten-year survival now exceeds 80%. 4 Patients with SB may require surgery throughout their life- time, from neonatal closure to cerebrospinal fluid (CSF) diversion procedures, urological intervention and major or- thopaedic surgery. Spina bifida results in multisystem co - morbidity which poses a diverse range of challenges to the anaesthetist.