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Spina Bifida - Types, Causes, Symptoms, Diagnosis, and Treatment

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Spina bifida is a neural tube defect. The Latin words directly translate to divided or split spine. Read the article below to learn more.

Written by

Dr. Shikha

Medically reviewed by

Dr. Faisal Abdul Karim Malim

Published At January 25, 2023
Reviewed AtFebruary 16, 2023

What Is Spina Bifida?

In the initial weeks of embryonic development, the neural tube, a layer of cells that give rise to the brain and spinal cord, fails to shut completely. This abnormality is known as spina bifida. It takes place when the brain, spinal cord, or meninges and their protective covering do not fully form. As a result, when the spine develops, the spinal column's bones do not completely close around the growing spinal cord nerves.

Permanent nerve injury could result from a portion of the spinal cord protruding through the spine. Spina bifida is categorized as a neural tube defect since it results from defects in the neural tube. It can be found anywhere along the length of the spine and is typically visible at delivery through an opening in the baby's back. It might also resemble a fluid-filled sac that has developed on the spine outside of the body. The spinal cord might or might not be contained within this sack.

What Are the Types of Spina Bifida?

Spina bifida can manifest in a variety of ways, including the extremely rare meningocele type, myelomeningocele, and spina bifida occulta.

  • Spina Bifida Occulta - Occulta is Latin for concealed. It is the most prevalent and moderate variety. A slight split or gap within one or more of the vertebrae bones is the outcome of spina bifida occulta. A lot of individuals with spina bifida occulta are completely unaware of their condition unless an imaging test performed for another reason reveals it.

  • Meningocele - A sac filled with spinal fluid protrudes through a gap in the spine in this uncommon form of spina bifida. The spinal cord is not in the fluid sac, and no nerves are impacted by this type. Meningoceles in babies can cause minor functional issues, such as those impacting the bladder and bowels.

  • Myelomeningocele - Myelomeningocele, often known as open spina bifida, is the most serious kind. The lower or middle back has numerous vertebrae along which the spinal canal is open. When the infant is born, the membranes and spinal nerves push through this opening, forming a sac on the baby's back that often exposes tissues and nerves. This elevates the risk of the baby contracting potentially fatal infections, and it may also result in bladder and bowel abnormalities and paralysis.

What Causes Spina Bifida?

It is unclear what all are the specific reasons causing spina bifida. But a combination of hereditary and environmental factors are involved. Even while genetics have a role, a baby born with spina bifida may not have any family members who also have the problem. Additionally, a deficiency in folic acid, often known as vitamin B9, is thought to contribute to spina bifida. Other elements that are thought to be important include: mothers with uncontrolled diabetes, certain medication, and obesity.

What Are the Symptoms of Spina Bifida?

The lumbosacral area of the growing spine is where the myelomeningocele lesion most frequently manifests itself. Myelomeningocele may result in various symptoms based on its location.

  • Bowel and bladder issues (incontinence).

  • Sexually inadequate to perform.

  • Sensation loss and numbness below the defect.

  • Various cognitive problems, including paralysis and the inability to move the lower legs.

  • Orthopedic issues like a club foot or issues with the knees or hips.

The severity of the problems typically increases with the height of the lesion on the spine. In many cases, the hindbrain herniates or descends into the upper section of the spinal canal in the neck, resulting in an Arnold-Chiari II malformation. This hindbrain herniation prevents the flow of cerebrospinal fluid, which can harm the growing brain and lead to hydrocephalus (fluid buildup in the brain). To drain fluid and treat hydrocephalus, a tiny tube is inserted into the ventricles of the brain (a procedure known as ventricular shunting).

How to Diagnose Spina Bifida?

Diagnosis for spina bifida can be made either before or after delivery. It is possible that spina bifida occulta will not be identified until late childhood or adulthood, if at all.

  • Prenatal testing includes screening procedures used to look for spina bifida and other birth abnormalities during pregnancy. Any queries or worries one may have regarding this prenatal testing should be brought up with their doctor.

  • Alpha-fetoprotein, or AFP, is a protein that the developing fetus generates. The amount of AFP that the infant has transferred to the mother's circulation through this straightforward blood test is measured. A high AFP level could indicate that the infant has spina bifida. An examination known as the "triple screen" that checks for neural tube abnormalities and other problems may include an AFP test.

  • An ultrasound is a particular kind of image of the infant. In some circumstances, the doctor can check to see if the infant has spina bifida or identify other potential causes of a high level of AFP. With this test, spina bifida is frequently detectable.

  • Amniocentesis is performed using a little sample of the amniotic fluid surrounding the unborn child drawn by the physician. The presence of spina bifida in the infant may be indicated by higher-than-normal AFP levels in the fluid.

  • Spina bifida may occasionally not be discovered until after the baby is delivered. Sometimes a baby's back has a dimple or a hairy patch that is seen for the first time after birth. To see the baby's spine and back bones more clearly, a doctor may use an imaging scan, such as an X-ray, MRI (magnetic resonance imaging), or CT (computerized tomography) scan.

Because the woman did not receive prenatal care or because an ultrasound did not produce clear images of the damaged region of the spine, spina bifida is occasionally not discovered until after the baby is born.

How to Treat Spina Bifida?

Each individual's spina bifida treatment will be unique due to the wide range of symptoms and severity. In rare circumstances, particularly with spina bifida occulta, no therapy may be necessary. Myelomeningocele and meningocele, however, need surgery to reattach the exposed sack and nerves. It might also need to be removed in part. The opening over the vertebrae will then be sealed by the surgeon. In order to prevent problems later in life, a shunt could be installed. The procedure might be done soon after the baby is born. Prenatal surgery can occasionally be performed while the unborn child is still in the womb. Individuals should discuss the advantages and disadvantages of these surgical procedures with their doctor.

There may still be some discomfort and incapacity even after surgery. The degree to which each symptom needs to be controlled will depend on the condition. Most people experience paralysis and bowel and bladder problems throughout their lifetime. Treatment options for persistent symptoms include:

  • Medication.

  • Physical therapy and rehabilitation.

  • Walking aids.

How to Prevent Spina Bifida?

Early in pregnancy is when spina bifida develops. By the time pregnancy starts, the majority of women are not even aware of it. Therefore, people should begin preventive measures for spina bifida if they are attempting to get pregnant and observe these precautions:

  • Take the folic acid vitamin that the doctor has recommended.

  • Include folic acid-rich foods like nuts, beans, and leafy green vegetables in their diet.

  • Talk to a doctor about any drugs or dietary supplements the individual is taking.

  • Make sure the diabetes is under control before getting pregnant.

  • Consult a doctor about a healthy diet and exercise regimen if someone is overweight.

  • Make sure the body does not get too heated from hot tubs, saunas, or a fever.

Conclusion:

Between mild and severe ranges, spina bifida can occur. Some individuals may have minimal or no disabilities. Others might have restrictions on their movements or functional abilities. Some individuals might even be paralyzed, unable to walk or move certain body parts. Even those with severe forms of spina bifida can lead fulfilling lives with the right care and management. If an individual has spina bifida, it is crucial to stay in touch with the medical team so they can monitor any changes or other medical concerns that can develop over the course of the lifetime. They will assist patients in efficiently managing their spina bifida, going forward.

Dr. Faisal Abdul Karim Malim
Dr. Faisal Abdul Karim Malim

Pediatrics

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neural tube defectsspina bifida
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