Total spina bifida cystica is a severe form of spina bifida, a birth defect in which the spinal cord and its protective covering do not develop properly. It is characterized by the presence of a sac-like protrusion on the back containing the spinal cord and its membranes. This protrusion may be covered by skin or may be open, exposing the spinal cord and its membranes. Total spina bifida cystica can cause a variety of physical and neurological problems, including paralysis, bladder and bowel control problems, and learning disabilities.

The symptoms of total spina bifida cystica can vary depending on the severity of the condition, but may include:

- Paralysis of the lower limbs
- Bladder and bowel incontinence
- Hydrocephalus (fluid buildup in the brain)
- Abnormal spinal curvature
- Abnormal development of the spinal cord
- Abnormal development of the vertebrae
- Abnormal development of the spinal nerves
- Abnormal development of the skin covering the spinal cord
- Abnormal development of the muscles and bones of the lower back
- Abnormal development of the hips and legs
- Abnormal development of the feet and toes
- Abnormal development of the reproductive organs
- Abnormal development of the urinary tract
- Abnormal development of the digestive tract
- Abnormal development of the eyes and

Total spina bifida cystica is caused by a failure of the neural tube to close properly during the first few weeks of pregnancy. This can be caused by a combination of genetic and environmental factors, such as a lack of folic acid in the mother's diet, certain medications, and exposure to certain toxins.

The treatments for Total Spina Bifida Cystica vary depending on the severity of the condition. Generally, treatments may include surgery to close the spinal opening, physical therapy, medications to control seizures, and bladder and bowel management. In some cases, a shunt may be placed to help drain excess fluid from the brain. Additionally, orthopedic surgery may be necessary to correct any deformities in the spine or legs.

The risk factors for Total Spina Bifida Cystica include:

1. Family history of neural tube defects
2. Low intake of folic acid during pregnancy
3. Maternal diabetes
4. Maternal obesity
5. Maternal use of certain medications, such as anticonvulsants, during pregnancy
6. Maternal exposure to certain environmental toxins, such as pesticides, during pregnancy
7. Maternal age over 35 years old

Total spina bifida cystica is a congenital condition that cannot be cured. However, there are medications and treatments available to help manage the symptoms. These include medications to reduce swelling, physical therapy to help with mobility, and surgery to close the spinal opening.