Spina Bifida

Spina Bifida

Spina bifida is a birth defect. Most children who have spina bifida do not have problems from it. It occurs when the bones of the spine (vertebrae) do not form properly around part of the baby’s spinal cord. It can affect how the skin on the back looks. And in severe cases, it can make walking or daily activities hard to do without help.

Spina Bifida Occulta

It is the mildest form of spina bifida. “Occulta” means hidden, meaning that the defect is covered by skin and not open. Most children with this type of condition never have health problems and the spinal cord is often unaffected. Some can have symptoms if the hidden defect is severe enough.

Spina Bifida Manifest Includes two types of spina bifida:

• Meningocele involves the meninges, the membranes responsible for covering and protecting the brain and spinal cord. If the meninges push through the hole in the vertebrae (the small, ring-like bones that make up the spinal column), the sac is called a meningocele.
• Myelomeningocele is the most severe form of spina bifida. It occurs when the meninges push through the hole in the back, and the spinal cord also pushes through. Most babies who are born with this type of spina bifida also have hydrocephalus, an accumulation of fluid in and around the brain.

Risk Factor:

• Family history of neural tube defects
• Folate deficiency
• Some medication
• Diabetes
• Obesity
• Increased body temperature

Complication:

• Physical and neurological problems: This may include lack of normal bowel and bladder control and partial or complete paralysis of the legs. Children and adults with this form of spina bifida might need crutches, braces or wheelchairs to help them get around, depending on the size of the opening in the spine and the care received after birth.
• Accumulation of fluid in the brain: Babies born with myelomeningocele also commonly experience accumulation of fluid in the brain, a condition known as hydrocephalus. Most babies with myelomeningocele will need a ventricular shunt — a surgically placed tube that allows fluid in the brain to drain as needed into the abdomen. This tube might be placed just after birth, during the surgery to close the sac on the lower back, or later as fluid accumulates.
• Infection in the tissues surrounding the brain: Some babies with myelomeningocele may develop meningitis, an infection in the tissues surrounding the brain, which may cause brain injury and can be life-threatening.
• Other complications: Additional problems may arise as children with spina bifida get older. Children with myelomeningocele may develop learning disabilities, including difficulty paying attention, problems with language and reading comprehension, and trouble learning math. Children with spina bifida may also experience latex allergies, skin problems, urinary tract infections, gastrointestinal disorders and depression.

Treatment:

• Initial Surgery: Meningocele involves surgery to put the meninges back in place and close the opening in the vertebrae. Myelomeningocele also requires surgery, usually within 24 to 48 hours after birth. Performing the surgery early can help minimize risk of infection that’s associated with the exposed nerves and may also help protect the spinal cord from additional trauma. During the procedure, a neurosurgeon places the spinal cord and exposed tissue inside the baby’s body and covers them with muscle and skin. Sometimes a shunt to control hydrocephalus in the baby’s brain is placed during the operation on the spinal cord.
• Prenatal Surgery: In this procedure which takes place before the 26th week of pregnancy surgeons expose a pregnant mother’s uterus surgically, open the uterus and repair the baby’s spinal cord.