What is Spina Bifida?
This is a portion of a grouping of defects of birth referred to as “neural tube defects”. This tube is the primary configuration that ultimately progresses into the spinal cord and brain of the baby as well as the tissues that encompass them.
Usually, this tube forms early during the pregnancy and is generally completed by the 28th day after conception. In those infants born with spina bifida, some share of this neural tube will fail to close properly or develop, thus producing flaws in the spinal cord as well as in the bones of the backbone.
This defect occurs in several degrees of severity. When treatment for spina bifida is needed, it is done thru surgery, but such treatment does not always resolve the problem completely.
Spina Bifida Symptoms and Types
Spina bifida happens in three (3) forms, each variable in how severe each is:
Spina Bifida Occulta
This is the mildest form causing a gap that is small in one or several of the vertebrae bones in the spine. Due to the nerves in the spine not usually being involved, many of those with this type of spina bifida have no symptoms or signs and there are no problems neurologically.
A clump of hair that is abnormal, a gathering of fat, a dimple that is small or a mark on the skin of the newborn above the defect might be the lone sign of the disorder. Many individuals who have “spina bifida occulta” do not even realize it until the problem is found while having an imaging procedure for a reason that is unrelated.
Meningocele
This is the form that is rarest, and the membranes that protect the spinal cord known as the meninges bulge out thru the gap in the vertebrae. Since the spinal cord normally develops, the membranes may be surgically removed with very little if any damage to pathways of the nerve.
Myelomeningocele
Also referred to as “open spina bifida”, is the more severe type – and is the form individuals normally think of when they use or hear the words “spina bifida”. In this form, the spinal canal of the baby stays open along with several vertebrae in the middle or lower back. Due to these openings, both the spinal cord and the membranes are protruding at birth, creating a sac on the baby’s back. In several cases, skin is covering this sac. Normally, however, nerves and tissues are exposed, causing the baby to be prone to infections that are life-threatening.
Neurological impairment – often will include paralysis or the loss of movement – is common. So are problems with bladder and bowel, seizures as well as other medical difficulties.
Spina Bifida Causes
Medical researchers are not sure what causes this defect. As it is with many problems, it seems to result from a combination of environmental and genetic risk factors, for instance family history of “neural tube defects” as well as a deficiency of folic acid.
Although physicians and medical researchers do not know for certain why spina bifida happens, they have identified several risk factors:
Family history of defects of the neural tube
Couples who have one child with a “neural tube defect” hold a somewhat greater hazard of delivering another baby with this identical defect. This risk rises if there are two (2) prior children who have been affected by this disorder. In addition, any woman born with a “defective neural tube” or with a relative who is close with one also has a larger risk of giving child birth to a baby with spina bifida. But, most babies with the defect are born to parents with no acknowledged family history of this condition.
Race
This condition is most common among Hispanics and whites.
Folate deficiency
Folate which is vitamin B-9 is vital to healthy fetal development. Folate is the usual type of the vitamin B-9. The form that is synthetic, found in fortified foods and supplements, is referred to as folic acid. A deficiency in folate raises the peril of spina bifida as well as other “neural tube defects”.
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Several medications
Medications known as anti-seizure, for instance valproic acid sold as Depakene is believed to be a cause in the development of “neural tube defects” especially when used while pregnant, since they seem to obstruct the body’s capacity to consume folate or folic acid.
Obesity
Obesity pre-pregnancy is linked with a bigger risk of “neural tube birth” deficiencies containing spina bifida.
Diabetes
Women who have diabetes and who do not control blood sugar levels will have a higher peril of having a baby with this defect.
Body temperature increase
There has been evidence that suggests body temperature that is increased and known as hyperthermia in the early months of pregnancy can raise the danger of this defect. Stirring the core temperature of the body by only three (3) to four (4) degrees F. over normal – about two (2) degrees C – because of fever or using of tanning beds, saunas, or hot tubs, has been linked with enlarged hazard of spina bifida.
If an individual has a risk factor for this defect – speak with the physician to decide if you must have a bigger dose or perhaps a prescription dosage of folic acid prior to the pregnancy beginning. If a woman takes medications, tell the physician. Some medications may be attuned to reduce any threat of spina bifida, if procedures are completed ahead of time.
Spina Bifida Treatment
Treatment for this defect is contingent on how severe the situation. “Spina bifida occulta” frequently does not usually need any treatment, but most other kinds of spina bifida do.
Surgery
Meningocele consist of surgery to put the meninges in place and then close the gap in the vertebrae. This type of defect also needs surgery, normally within a few hours to a few days after birth. The earlier this surgery is done will help minimize any risk of an infection developing that is linked with the nerves that are exposed as well as might also help in defending the spinal cord from any added trauma. While doing this surgery, a neurosurgeon will space the spinal cord and tissue exposed inside the infant’s body and then shields them with skin and muscle. Frequently a shunt which manages hydrocephalus in the infant’s brain is placed there while doing surgery on the spinal cord.
Prenatal surgery
This is a procedure which is not available widely – surgeons expose the pregnant mother’s uterus, open the uterus and repair the spinal cord of the fetus. This surgery is performed between the 19th and the 25th week of the pregnancy.
Medical professionals have investigated the success of any prenatal surgery for this defect. The advocates of surgery on fetuses say that the function of the nerves in infants with this disease seems to get worse quickly after birth, so it might be best to do repairs while they are still in utero. Children who have this fetal surgery do seem to need much fewer shunts and are much less likely to need walking devices or crutches. But this surgery does pose risks to the mother and it does seem to greatly increase the risk of delivery prematurely.
Ongoing care
Treatment does not end with any surgery. In babies with myelomeningocele, nerve damage has already happened and ongoing care from a team of surgeons, physicians as well as therapists is needed. Bladder and bowel problems as well as paralysis normally remains and treatment for these problems normally start soon after birth. Those infants with myelomeningocele must also start exercises preparing their legs for walking with crutches or braces when older.
Additionally, infants with myelomeningocele might need further surgeries for a variety of problems. Many have a spinal cord that is tied – condition where the spinal cord becomes bound to scars of the closure and is less capable to grow properly in length while the baby grows. This “tethering” that is progressive may create loss of function of the muscle to the bladder or bowel as well as the legs. The surgery may limit disability degree and might also restore other functions.
Cesarean birth
This also might be a portion of the management for spina bifida. In majority of babies with spina bifida, the situation is usually discovered before birth and cesarean birth is believed to be a much safer method in delivering these infants. Delivery prior to labor starting might reduce the amount of damage to the exposed nerves of the baby so many specialists now do endorse a cesarean section.
Spina Bifida Life Expectancy
The prognosis for infants and children with these defects has dramatically changed over the years. A recent study issued in 2001 stated that with proper care medically, at least 75% of infants born with the more severe form of spina bifida which is myelomeningocele will likely live into their early adulthood years. The authors of this study have an opinion that constantly providing supportive care for these adults is a challenge.
Spina Bifida Pictures
