Spina bifida

Alternative Names

Spina bifida, Cleft spine

What is Spina bifida

Spina bifida is a developmental congenital disorder characterized by defective closure of the bony encasement of the spinal cord through which the spinal cord and meninges may or may not protrude. Spina bifida is part of a group of birth defects called neural tube defects. Spina bifida divided into 3 types: spina bifida occulta, spina bifida cystica with meningocele, and spina bifida cystica with myelomeningocele. Ususally it is placed in the lumbar and sacral areas. Myelomeningocele is the most dangerous type and it may turn into disability in most affected individuals.

Signs and symptoms

The most common signs and symptoms include:

• leg weakness and paralysis
• orthopedic abnormalities (i.e., club foot, hip dislocation, scoliosis)
• bladder and bowel control problems, including incontinence, urinary tract infections and poor renal function
• latex allergy
• pressure sores and skin irritations
• abnormal eye movement

Possible complications

If this disease develops in children they may have fewer friends and spend less time with peers. They may be more unsociable and more passive in some situations. Children with spina bifida have also reported feeling less close to their friends and feel they do not receive as much emotional support from their friendships. Many social difficulties continue to develop in adulthood.

What causes

Currently scientists and doctors cannot define the causes of this disease. It occurs from a combination of genetic and environmental risk factors such as a family history of neural tube defects and folic acid deficiency.

Prevention

It is recommended to take folic acid in supplement form at least one month before conception and during the first trimester of pregnancy. It helps to decrease the risk of spina bifida and other neural tube defects.

Treatment

The treatment plan should be determined by your doctor. It depends on many factors. Spina bifida occulta usually does not demand any treatment, but other forms of spina bifida do:

• 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.

• 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.

• Ongoing care

Treatment does not end with the initial surgery. In babies with myelomeningocele, irreparable nerve damage has already occurred and ongoing care from a multidisciplinary team of surgeons, physicians and therapists is usually needed. Paralysis and bladder and bowel problems often remain and treatment for these conditions typically begins soon after birth. Babies with myelomeningocele may also start exercises that will prepare their legs for walking with braces or crutches when they're older.

• Cesarean birth

Cesarean birth also may be part of the treatment for spina bifida. Many babies with myelomeningocele tend to be in a feet-first (breech) position. If your baby is in this position or if your doctor has detected a large cyst, cesarean birth may be a safer way to deliver your baby.