Spina Bifida
Overview
Spina Bifida is broader term for a birth defect in which the backbone and spinal canal do not close before birth. Spina bifida includes any birth defect involving insufficient closure of the spine.
Spina bifida occulta is a condition in which the bones of the spine do not close but the spinal cord and meninges remain in place and skin usually covers the defect.
Meningoceles is a condition where the tissue covering the spinal cord sticks out of the spinal defect but the spinal cord remains in place.A myelomeningocele is a congenital (present at birth) deformity and the most serious form of spina bifida. It can occur anywhere along the spinal cord. With myelomeningocele, the spinal canal is open.
Symptoms and Types
Causes The cause of spina bifida is unknown. However, folic acid deficiency is thought to play a part in neural tube defects. It is recommended that any woman considering becoming pregnant take 0.4 mg of folic acid a day. Pregnant women need 1 mg per day.
Also, if a child is born with spina bifida, subsequent children in that family have a higher risk than the general population. Some theorize that a virus make play a role, since there is a higher rate of this condition in children born in the early winter months. Research also indicates possible environmental factors such as radiation.
Symptoms of Spina Bifida A newborn may have a sac sticking out of the mid to lower back. The doctor cannot see through the sac when shining a light behind it. Symptoms include:
Loss of bladder or bowel control
Partial or complete lack of sensation
Partial or complete paralysis of the legs
Weakness of the hips, legs, or feet of a newborn
The exposed spinal cord is susceptible to infection.
Other symptoms may include:Hair at the back part of the pelvis called the sacral areaDimpling of the sacral area
Treatment and Care
After birth, surgery to repair the defect is usually recommended at an early age. Before surgery, the infant must be handled carefully to reduce damage to the exposed spinal cord. This may include special care and positioning, protective devices, and changes in the methods of handling, feeding, and bathing.
Antibiotics may be used to treat or prevent infections such as meningitis or urinary tract infections.
Gentle downward pressure over the bladder may help drain the bladder. In severe cases, drainage tubes, called catheters, may be needed. Bowel training programs and a high fiber diet may improve bowel function.
Orthopedic or physical therapy may be needed to treat musculoskeletal symptoms.
Neurological losses are treated according to the type and severity of function loss.
Follow-up neurologic testing as the child gets older helps to guide rehabilitation.
Frequent doctor's visits will be needed early on if your baby has severe spina bifida. Doctors use these visits to make sure that treatments are working and to determine whether the child needs more surgery.
A baby with severe spina bifida may need ongoing physical therapy to help strengthen the muscles by exercising the arms and legs. You will be able to help your baby do many of these exercises at home.