Spina Bifida:Symptoms, Causes and Treatment

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Overview

Spina bifida is a birth defect that can happen anywhere along the spine. It begins in the womb when the tissues that should fold to form the neural tube do not close or do not stay closed completely. This causes an opening in the vertebrae, which will affect the central nervous system.

Spina bifida is one of several forms of spinal dysraphism or malformation of the spinal cord. There are three main types of spina bifida: spina bifida occulta, meningocele, and myelomeningocele. Spina bifida most commenly occurs in the lower back, but in rare cases, it may be the middle back or neck.

Through various statistics, about 1,500 to 2,000 babies out of the 4 million newborns in the U.S. every year have spina bifida.

Symptoms

Spina bifida might cause physical and intellectual disabilities. Symptoms of Spina bifida vary from the type and severity of the neural tube defect.

For spina bifida occulta, the most obvious sign might be an abnormal tuft of hair or a birthmark on the skin above the spinal defect. However, since the spinal nerves usually aren’t involved, there are no other signs or symptoms.

For meningocele, you can see a sac filled with fluid through the infant’s back, but this sac doesn’t include the spinal cord. And there may be a thin layer of skin over the sac.

For myelomeningocele, it is the most severe form of spina bifida. The spinal canal remains open along several vertebrae in the lower or middle back. When children are just born, the membranes and the spinal cord or nerves protrude and thus form a sac. Tissues and nerves usually are exposed mostly without skin covering.

Other symptoms of myelomeningocele include:

  • Weak leg muscles
  • Unusual-shaped feet, uneven hips, or a curved spine
  • Seizures
  • Allergy to latex
  • Bowel or bladder problems
  • Difficulty with breathing, swallowing or moving their upper arms
  • Overweight

Causes

The certain causes for spina bifida are not fully known. According to some research, spina bifida appears to result from a combination of genetic and environmental factors, such as a family history of neural tube defects and folate deficiency.

Having a child with spina bifida increases the chance that another child will also have spina bifida by almost 8 times. But it needs to be studied further. Besides, the condition is more common among white and Hispanic babies, especially for girls. Also, women who have diabetes that isn’t well-managed and who are obese may be more likely to have a child with spina bifida.

Diagnosis

Generally, spina bifida can be diagnosed during pregnancy or after the baby is born.

During pregnancy, there are three prenatal tests to check for spina bifida. Before you make any decisions for prenatal testing, ask the doctors for correct advice.

  • AFP (alpha-fetoprotein)–It is a simple blood test that measures how much AFP has passed into the mother’s bloodstream from the baby. If there is a high level of AFP, it might mean that the baby has spina bifida. AFP test is a part of a test called the “triple screen”, which is used for detecting neural tube defects and other problems.
  • Ultrasound–It is a type of picture of the baby on a computer monitor. In some cases, the doctor can confirm whether the baby has spina bifida or find other reasons for a high level of AFP by using ultrasound.
  • Amniocentesis–If the blood test shows a high level of AFP but the ultrasound looks normal, the doctors will recommend amniocentesis. Doctors take a small sample of the amniotic fluid surrounding the baby in the womb. If it is higher than average levels of AFP in the fluid, it might mean that the baby has Spina Bifida.

After a baby is born, the doctor may confirm the disease by seeing a hairy patch of skin or a dimple on the baby’s back. In addition, a doctor can use an image scan, such as an X-ray, MRI or CT to get a detailed view of the baby’s spine and the bones in the back.

Treatment

Research has suggested that by taking adequate folic acid before and during early pregnancy, spina bifida can possibly be prevented.

While early treatment for spina bifida is necessary, the common treatment is surgery after delivery, though such treatment doesn’t always completely resolve the problem. The surgery aims to prevent further damage to the nervous tissue and to prevent infection.

Pediatric neurosurgeons will operate to close the opening on the back. By having surgery, the spinal cord and its nerve roots are put back inside the spine and covered with meninges. In addition, surgeons may surgically install a shunt to provide a continuous drain for the excess cerebrospinal fluid produced in the brain, as occurs with hydrocephalus. Shunts most commonly drain into the abdomen or chest wall.


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