Spina bifida in which the defect is covered by normal soft tissue with normal AFP levels is called which type?

• A. Occulta
• B. Aperta
• C. Encephalocele
• D. Meningocele

Answer: (A)

This is spina bifida occulta. It represents a closed spinal dysraphism where the vertebral arch fails to fuse but the overlying soft tissues remain intact, so there is no protrusion of meninges or neural tissue. Because there’s no exposure of neural elements to amniotic fluid, maternal (and fetal) AFP levels stay normal. Clinically you might see a subtle skin marker over the spine, such as a tuft of hair or a small dimple, and there are usually no neurologic deficits. In contrast, open defects in spina bifida (aperta) involve protrusion of neural tissue or meninges and typically show elevated AFP. Encephalocele is a cranial defect, not spinal, so it’s not the same category.