Spina Bifida

Spina Bifida is a common and disabling disorder in which the embryonic neural tube does not fully close. Physical medicine and rehabilitation specialists work collaboratively alongside orthopaedic surgeons and urologists at Shriners Hospitals for Children – Northern California to help children with spina bifida lead active, productive lives.

Patients are generally seen in our Spina Bifida Clinic at least once per year. Typically more for younger children. Clinics are held at least five times per month, on Tuesday’s and Friday’s. Every clinic is fully booked months in advance, so we urge you to call as early as possible to change or cancel any clinic appointment.

Persons with Spina Bifida, or pregnant women who are carrying a fetus diagnosed with Spina Bifida, can be referred to the Spina Bifida program by their primary care provider or via self-referral.

Medical Concentration

  • Myelomeningocele, myelodysplasia, lipomeningocele
  • Non-surgical and surgical treatment to achieve bowel and bladder continence
  • Surgical and orthotic treatment of orthopaedic deformities (legs and spine)
  • Central nervous system (brain and spinal cord)
  • Genitourinary (bladder, kidney)
  • Gastrointestinal (colon)
  • Musculoskeletal (spine and lower extremities)

We treat children with the following conditions:

  • Lipomeningocele
  • Meningocele
  • Myelomeningocele
  • Sacral agenesis
  • Spina Bifida
  • Spinal cord lipoma
  • Split cord malformation
  • Terminal myelocystocele
  • VATER /VACTERL associations

What to expect on the day of the clinic

During the clinic visit, the multidisciplinary team will evaluate and provide or recommend treatment for those health issues relating directly to Spina Bifida. The Spina Bifida team will also communicate their recommendations to the primary care provider, who will coordinate all other health matters.

What to expect between clinic visits

Between clinic visits, clinic patients may see specialists from among the clinic team as indicated. Also, our nurse specialists provide case management services on a year-round basis, coordinating the many services our patients require within and outside the Shriner Hospital system.

Every patient is encouraged to develop a relationship with a personal physician. This primary care provider will be the first point of contact and handle routine health matters in a medical facility close to your home.  We encourage our patients to contact their primary providers or local facility immediately if there is any suspicion of a new problem, such as a wound or urinary tract infection.  By seeking care early, many problems can be minimized. Please also update the Spina Bifida Nurse Case Manager so she can help. If your primary provider has questions, or about any of our clinic’s recommendations, please invite them to contact us.

Clinic philosophy and structure

With advances in medicine and coordinated health care services, individuals with NTDs  are living longer and healthier lives. People with spina bifida are now expected to outlive their parents regardless of the severity of their neural tube defect.

The professional staff of the Regional SBC hopes to help our patients achieve full participation in life with maximum opportunity.  It is also our goal to optimize functional and self-care abilities. We emphasize self-care skills when achievable, and self-care agency (the ability to secure needed assistance) when appropriate.

These goals underscore the need for transition planning throughout the life span.  We see patients until the age of 21 and work with patients and family to create an individual healthcare team plan for the person with Spina Bifida.

The Medical Team

Maya Evans, M.D.
Medical Director of Spina Bifida Program
Dr. Evans is Board Certified by the American Board of Physical Medicine and Rehabilitation in Brain Injury Medicine, Pediatric Rehabilitation Medicine and Physical Medicine and Rehabilitation.

Craig McDonald, M.D.
Associate Medical Director
Dr. McDonald is Board certified in both Physical Medicine and Rehabilitation and Pediatric Rehabilitation Medicine.  He also is Professor of Clinical Physical Medicine and Rehabilitation and Professor of Clinical Pediatrics at the University of California Davis, School of Medicine.

Vedant Kulkarni, M.D.
Dr. Kulkarni’s work is devoted to improving outcomes for children with neuromuscular conditions, hip disorders and traumatic injuries.

Sam Ciricillo, M.D.
Neurological Surgeon
Dr. Ciricillo is a Diplomate with the American Board of Neurological Surgery and the American Board of Pediatric Neurological Surgery, and a Fellow of the American College of Surgeons.

Eric Kurzrock, M.D.
Urologic Surgeon
Dr. Kuzrock is Board certified by the Medical Board of California, Physician and Surgeon, and the American Board of Urology and  the recipient of numerous awards.

Jennifer Yang, M.D.
Urologist
Dr. Yang specializes in providing urologic care for infants and children.

Susie Williams, BSN, RN
Spina Bifida & Urology Care Manager

Katie Bastian, RN
Spina Bifida & Urology Care Manager

Multi-Disciplinary Approach to Care

All patients benefit from the expertise of the entire medical team, which provides multi-disciplinary clinics. Coordinated by the Case Manager, the collaborative approach to care extends to nurses, physical therapists, orthotists, and child-life therapists who treat patients in mind, body and spirit. The expertise, experience and environment of care create a synergy that distinguishes the Spina Bifida program at Shriners Hospitals for Children.

Research

Diana Farmer, M.D., Chief of Pediatric Surgery and Chair of Surgery at UC Davis, performs and studies repair of neural tube defects in-utero. Meanwhile, scientific researchers at SHCNC search for cures. Adding folic acid, a vitamin, to the maternal diet diminishes the frequency of spina bifida, but how folate does this remains a mystery. Through microscopic observations of the developing frog, scientists at Shriners Hospital have obtained novel evidence that folate increases the ability of cells on the two sides of the spinal cord to fuse together and prevent spina bifida. Another study is investigating whether a protein that controls the development of arms, legs, the face and brain may be involved in the etiology of spina bifida.

Patient Referral

916-453-2191
916-453-2111 (Emergency Referral)
916-453-2395 (fax)
referrals.ncal@shrinenet.org

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