Where the lesion is open, most surgeons prefer to operate as soon as possible, usually within the first 24 hours of birth. Two main reasons for this are to prevent further drying and damage of the nervous tissue and to prevent infection. During the operation, the spinal cord and its nerve roots are put into place and covered with skin. The resulting scar can be vertical or horizontal or sometimes of a more complicated pattern. It is important to remember that this surgery will not 'fix' the nerve damage, just prevent more damage from occurring.
Some babies have healthy skin covering the spinal defect at birth.
In these cases, surgery is not urgent and is usually left until a later date, if it needs to be done at all. Another problem that frequently occurs with spina bifida is hydrocephalus and this needs early treatment. This is a Latin term and means 'water on the brain'. This fluid helps to protect the brain from bumping around inside the skull when we move. The CSF is constantly absorbed into the bloodstream as it travels.