• Myelomeningocele - Spina bifida | © Pohlig GmbH
    Clinical picture
    Spina bifida (MMC)

Born with an open back

What exactly is spina bifida / myelomeningocele?

Myelomeningocele (MMC) - Spina bifida | © Pohlig GmbH

Myelomeningocele (MMC), also known as spina bifida or open back, is a congenital deformity of the spinal cord. This is due to a lack of closure of the unfinished spinal cord in the womb. Symptoms can vary widely after birth.

There are two different types of spina bifida:

  • Spina bifida occulta: This form of spina bifida is invisible from the outside. Neither the spinal cord skin nor the spinal cord itself is involved in the split vertebral arch. Since the spina bifida occulta is usually symptomless, no treatment is necessary.
  • Spina bifida aperta: Spina bifida aperta is the open or visible form of spina bifida. Symptoms vary depending on which parts of the spinal cord are affected and the level of the gap in the spine.



In two thirds of all cases, the spinal cord is damaged in the area of the lumbar spine or below. Symptoms range from increased sensitivity in the area of the lower extremities to minor impairments of walking ability and paraplegia, as well as disorders of bladder and bowel function.

In addition, this disease can lead to deformities of the spine and legs.

The walking abilityof MMC patients depends entirely on the level of neurological damage. If there is paralysis from segment L2 upwards, walking ability is generally not achieved.

In the case of paralysis between L2 and L4, walking ability is restricted. In these cases, however, the affected children rarely walk for more than one hour a day and otherwise sit in the wheelchair. In cases of paralysis at the lumbosacral level, the affected children are usually able to walk well with orthosis or even with pads.

Foot malpositions are relatively common in patients with MMC. These are often club foot and calcaneal foot. In addition, movement restrictions (contractures) or hip joint dislocations may occur at the hip joints due to muscle imbalance. Muscle imbalance can cause extension and flection deficits in the knee joints. There can also be spinal deformities (particularly in at least every second patient scoliosis), fractures, epiphyseolyses and, possibly, neurological problems, such as in the context of hydrocephalus.
To learn to stand and walk, extensive orthopedic and rehabilitation treatments, intensive movement therapy and sometimes operations on the feet, knee and hip joints and spine are often required.

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Aschau Children’s Clinic

The Orthopedic Children’s Clinic in Aschau is one of the largest specialist clinics for pediatric orthopedics in Central Europe.

Interdisciplinary treatment approach

When it comes to orthopedic treatment for infants and children, it is extremely important for all parties to pull together: parents, doctors, technicians and therapists.

Physiotherapie | © Pohlig GmbH

Physiotherapists at our headquarters and at some POHLIG branches support the individual care of our spina bifida patients.

Felix dreams of participating in the Paralympics

Canoeing with Spina bifida

Felix is thirteen years old and is soon training for the German Para Canoe national team. Since birth, the young competitive athlete has suffered from spina bifida, a spinal cord injury that makes walking difficult. That’s why Felix relies on orthoses and his wheelchair in everyday life. However, this does not prevent him from honing his technique on his home river, the Main, for hours. After all, he has big goals...

Start as early as possible!


The degree of possible deformities and their effect on the neuromotor development of the child are determined by the height at which the spinal cord is damaged. If you know about the level of paralysis at an early stage, many problems can be treated preventively. Therefore, determining the extent as early as possible plays a crucial role in therapy planning.

The central therapeutic objective is to achieve the best possible relief of the patient in their personal and social environment. When treating children with MMC, we therefore attach great importance to interdisciplinary cooperation between doctors, orthopedic technicians, physiotherapists, occupational therapists and parents.

Myelomeningocele (MMC) - Spina bifida | © Pohlig GmbH

Treatment options with orthoses

Our aim is to make the best use of the child’s existing physical possibilities, achieve maximum mobility and strive for the prevention or treatment of deformities.

For standing or walking, patients with MMC generally rely on walking orthoses that replace the non-existent muscle function. These assistive devices need to be readjusted to the patient’s height and abilities as they grow. The timing at which a walking orthosis is prescribed is based on the child’s motor development,

taking into account that the milestones of physical development are delayed compared to a non-paralyzed child. However, an erect stance should be aimed for no later than the end of the second year of life.

It is generally worthwhile to help affected children become mobile with the aid of orthoses: Studies have shown that patients who are made vertical during the growth phase suffer significantly less from fractures and pressure marks. They are also more independent and have better transferability.

Weak legs

Fabian can walk with orthoses

Fabian is seven years old and has spina bifida. The first grader shows you how to put on a thigh orthosis. It replaces Fabian’s lack of muscle function in his legs and allows him to move independently from A to B.

All-round care!

We have the solution

Our aids are individual components of the medical and therapeutic treatment concept. You can achieve amazing results for MMC patients can be achieved in combination with physiotherapy and rehabilitation aids.

Whether you are looking for custom-made functional and positioning heels, seat shells, wheelchairs, standing and walking aids, everyday aids or orthopedic footwear – we provide you with everything you need!

Unterschenkel-Fuß-Orthese - PRINTORTHESE® | © Pohlig GmbH