The standard treatment for a defect that has not been closed by fetal surgery is closure within a few days after birth. Unfortunately, this has no influence on the paralysis, as the neurological damage has already been done. Since 2011 prenatal, i.e. fetal, surgery has offered the possibility of a significant improvement in both the paralysis and the hydrocephalus. A fetal operation is therefore an important alternative to an operation after birth. Our Center offers this possibility and has already performed many successful prenatal operations for spina bifida.