Spina bifida can be congenital or acquired. In the majority of cases, spina bifida is caused by a congenital condition in which a fetal developmental defect in utero affects the closure of the spine, resulting in congenital spina bifida, which can lead to an epidural sac leak and associated neurological damage. While the majority of patients with spina bifida have the condition, a small percentage of patients have an acquired injury, such as a violent injury to the spine that results in a rupture of the spinous process and vertebral plate, resulting in a man-made spina bifida.