Spina bifida belongs to a group of congenital abnormalities known as neural tube defects. The neural tube refers to the embryonic structure that ultimately develops into the newborn’s spinal cord and brain and the tissues that envelop them.
In normal cases, the neural tube develops during the early stage of pregnancy and seals by the 28th day after conception. In newborns with spina bifida, a part of the neural tube does not form or close properly, leading to abnormalities in the bones of the backbone and in spinal cord
Spina bifida can be found in different levels of severity. Spina bifida is usually treated via surgical methods, when treatment is needed. However, surgery may not always fully resolve the defect.
Symptoms of spina bifida
Spina bifida can be found to occur in three different forms, each with varying severity levels.
Spina bifida occulta:
It is the mildest type of spina bifida. It causes a tiny gap or separation in one or many bones that form the spine. Since there is no involvement of the spinal nerves, a majority of the children affected by this type of spina bifida experience no neurological issues and do not elicit any symptoms
The signs of spina bifida occulta may occasionally be visible on the baby’s skin above the spinal abnormality and include:
- Skin discoloration
- An irregular tuft of hair
- A birthmark or a tiny dimple
- An accumulation of fat
This is a rare type of spina bifida, wherein the protective membranes that cover the spinal cord jut out through the vertebral opening. The spinal cord tends to form normally and hence such membranes can be surgically removed without causing any harm to the nerve pathways
It is also called open spina bifida and is the most serious form of the birth defect.
In myelomeningocele, the newborn’s spinal canal does not close along many vertebrae in the middle or lower back. The presence of such an opening results in the protrusion of the spinal cord as well as the membranes, which develops into a sac on the back of the bay. In a few instances, skin can enclose the sac. However, the nerves and tissues usually remain exposed, increasing the risk of life-threatening infections in the newborn.
Besides neurological problems, some of the associated symptoms include the following:
- Orthopedic difficulties like a curved spine or scoliosis, malformed feet and imbalanced hips
- Problems of the bladder and bowel
- Weakness of the muscles, which may occasionally involve paralysis
- Seizures, particularly if the affected child needs a shunt
Causes of spina bifida
The causes of spina bifida are not known as yet. It is believed that the condition may be caused due to a combination of environmental and genetic risk factors such as deficiency of folic acid and a family history of neural tube defects, etc.
Some of the risk factors that increase the vulnerability to the baby developing spina bifida are discussed below:
- Spina bifida tends to occur more in Hispanics and Caucasians than others
- Folate is essential for the healthy growth of a baby. It is a naturally occurring form of vitamin B-9 and its synthetic form is known as folic acid. Deficiency of folate increases the susceptibility to developing spina bifida and other forms of neural tube defects
- A family history of neural tube defects can increase the risk, but it has been found that a majority of the babies with spina bifida have been born to parents with no history of the disorder.
- Diabetic women who do not undergo treatment to control the levels of blood sugar are at increased risk to giving birth to a child with spina bifida
- Anti-seizure drugs consumed during pregnancy have been found to increase the risk to neural tube defects. This may be because such medications disturb the body’s capability to use folic acid and folate
- A few studies indicate that hyperthermia or excessive body temperature during the first few weeks of pregnancy can increase the risk to the baby developing spina bifida
- Obesity before pregnancy is also related to increased vulnerability to developing neural tube birth defects that includes spina bifida
Spina Bifida Treatment
The treatment of spina bifida is dependent on the severity of the disorder. Spina bifida occulta generally does not need to be treated, while other forms of condition may be treated in the following ways:
- Meningocele is treated via surgery wherein the membranes are put back into place and the vertebral opening is closed
- Myelomeningocele is treated via surgery within 24 to 48 hours post birth. The exposed tissues and spinal cord is placed back in the body and covered with muscle and skin
- Prenatal surgery to correct the defect may be conducted before the 26th week of pregnancy. However, it is risky and carried out as per individual cases.
- The treatment for spina bifida does not end with surgery, and further treatment by a multidisciplinary team of surgeons, therapists and physicians for the many associated complications and various symptoms of spina bifida is generally required.
Spina Bifida Life Expectancy
With progress in medical technology, the life expectancy of Spina Bifida has indeed increased. 75 percent of people who have Spina Bifida live till early adulthood and there are many who continue for years after that. The life expectancy of Spina bifida affected children depend on the severity at birth, but even the most severe ones can live long with physical therapy and surgery. By administering antibiotics that can prevent infections to the spinal cord, one can prevent any life threatening disorders and diseases. Surgery in the early stages post birth can also help close the gap between verterbrae and restore nerve function especially in cases like myelomeningocele or meningocele.
Spina Bifida Pictures