The Vall d’Hebron Spina Bifida Unit, a national reference in intrauterine surgeries, celebrates 40 years of experience

On Spina Bifida Day, we share the story of one of our patients: “We went to Vall d’Hebron because we were told they were the best in spina bifida.”

21/11/2025

Israel was still in his mother Ruth’s womb when he was diagnosed with spina bifida. “We went to Vall d’Hebron because we were told they were the best in spina bifida, and we ended up in Silvia’s hands,” explains Gabriel, Israel’s father. A long conversation with Dr. Sílvia Arévalo, Head of the Fetal Pathology Section and obstetrician specialized in Fetal Medicine and Surgery, led them to the conclusion that Israel needed to undergo surgery in the womb to correct the malformation.

Dr. Sílvia Arévalo explained that “in cases diagnosed intrauterinely, families who decide to continue the pregnancy are recommended prenatal fetal surgery, as it has been shown to reduce the complications the child may face at birth.” The trust the doctor built with Israel’s parents made them confident in her and agree to the surgery. “Everything went well, and two weeks later Israel was born, and soon after he started working with the rehabilitation team,” shared Gabriel.

“Patients must be able to become independent in daily life activities. The therapeutic approach must have a multidisciplinary team capable of addressing all the problems these complex patients may present,” explains Dr. Mar Meléndez, specialist in Physical Medicine and Rehabilitation. That’s why they started working with Israel from a very young age. The Physical Medicine and Rehabilitation team, together with the Spina Bifida Unit, made up of various professionals, has been able to improve the child’s condition.

“Thanks to the effort of the professionals and all the work done since Israel’s birth, the child’s progress has been very good. He crawls, stands up in his own way… He has independence and mobility,” confirms Gabriel.

Spina Bifida

Spina bifida is a group of congenital malformations that affect the central nervous system. These malformations can be open, such as myelomeningocele, which have serious consequences, but there are also closed forms of spina bifida with milder effects.

A unit with over 40 years of experience

The Vall d’Hebron Spina Bifida Unit is the only one in the country that cares for both pediatric and adult patients. “It is very important that patients can be treated regardless of age,” explains Dr. Mar Meléndez.

Having a unit focused on both pediatric and adult care is key to following up on active treatment without needing to change centers, ensuring patients feel supported throughout all stages of life.

For this reason, the Vall d’Hebron Spina Bifida Unit has a multidisciplinary team including Fetal Medicine specialists; neurosurgeons; urologists; pediatric surgeons; specialized nurses; and the rehabilitation team, which integrates physiatrists with support from physiotherapists and occupational therapists.

The therapeutic goals for these patients are to reduce the impact of complications on their lives. First, hydrocephalus is treated by placing shunts to preserve cognitive capacity. Second, strict control of kidney function and sphincter continence management is carried out. Finally, the aim is to achieve independent mobility and autonomy in daily life activities.

“S’ha d’aconseguir que els pacients arribin a ser autònoms en les activitats de la vida diària. L’abordatge terapèutic ha de disposar d'un equip multidisciplinari capaç de resoldre tots els problemes que poden presentar aquests pacients tan complexos”

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