Below is an instruction from Human. Write a response.
    ### Instruction:
    What are the genetic changes related to spina bifida ?
    ### Response:
    Spina bifida is a complex condition that is likely caused by the interaction of multiple genetic and environmental factors. Some of these factors have been identified, but many remain unknown.  Changes in dozens of genes in individuals with spina bifida and in their mothers may influence the risk of developing this type of neural tube defect.
    