What is the primary complication associated with the most severe form of spina bifida?

The primary complication associated with the most severe form of spina bifida, known as myelomeningocele, is indeed the risk of life-threatening infections. In this condition, the spinal cord and its protective membranes protrude through an opening in the spine, leading to significant neurological impairments, but also exposing the spinal cord and surrounding structures to the external environment.

This exposure makes individuals particularly susceptible to infections, such as meningitis, which can arise when bacteria enter the cerebrospinal fluid through the defect. The risk of infection is heightened due to the presence of open wounds and the potential for impaired immune responses in affected individuals. This is a critical concern because if not managed promptly, these infections can lead to severe complications and increased morbidity.

Other complications like muscle weakness, joint contractures, and hearing loss are certainly relevant to spina bifida and can affect quality of life; however, the immediate threat posed by infections in the context of myelomeningocele makes them the most critical focus for treatment and management.