Spina bifida is a type of birth defect. This type is called a neural tube defect. In spina bifida, a baby's spine does not close completely during early pregnancy. It can begin to develop in a fetus before the mother even knows she is pregnant. In some cases, structures that should be in the spinal canal can slip out. The structures affected involved may include:
There are three kinds of spina bifida:
This is the least severe form and can have:
In this case the membranes poke through an open part of the spine. This forms a cyst. Spinal fluid can leak out. This type can be treated.
This is the most severe form of spina bifida. In this case, the cyst contains membrane, nerve roots, and sometimes the spinal cord. This type can result in severe problems such as:
The cause is not known. As with many other birth defects, there is a strong genetic factor. Many studies have shown a link between a low folate diet in the mother and birth defects. The low folate diets are significantly associated with spina bifida.
Factors that increase the risk of spina bifida include:
The most immediate symptom of meningocele and myelomeningocele:
Infants and children with spina bifida may experience the following long-term symptoms:
The chance of spina bifida can be assessed before birth. This process uses a blood test. It is called the maternal serum alpha-fetoprotein (MSAFP) screening test. If the test predicts a high risk of neural tube defects two more tests will be done:
A diagnosis before birth can help you and your doctor make plans. A special delivery room will help lead to a quick surgery after birth. It can also give you some time before delivery to learn more about this condition and how to care for your child.
After birth, meningocele and myelomeningocele are usually apparent on physical exam. Many tests will be needed. They will help to determine the extent of internal deformities to the bones and nerves. The kidneys can also often become damaged. They will need to be watched closely.
Most children with occulta spina bifida will never be diagnosed. This condition rarely causes any symptoms. It also has few complications. It may be discovered during a routine medical exam. It may also be found following x-rays of the spine.
Treatment for myelomeningocele spina bifida is very complicated and may include:
Extensive surgery is done on the baby 24-48 hours after birth. During surgery, the nerves, membrane, and spinal cord are put back into the spine. They are then covered with skin. Prompt surgery can prevent further nerve damage. It cannot reverse damage that has already occurred. More serious forms of spina bifida may require more surgeries. They are done throughout childhood.
Therapists teach parents how to exercise the infant's legs and feet. Walkers, braces, and crutches will often be needed for mobility.
Complications of spina bifida can be ongoing and extensive. It will be important for you to work with a team of doctors. They should be able to provide the best care and support for you and your child. Team members may include:
To help reduce the chance that your baby will be born with spina bifida:
RESOURCES:
March of Dimes
http://www.modimes.org/
Spina Bifida Association of America
http://www.sbaa.org/
CANADIAN RESOURCES:
Sick Kids
http://www.sickkids.ca/
Spina Bifida and Hydrocephalus Association of Canada
http://www.sbhac.ca/
References:
American Academy of Pediatrics website. Available at: http://www.aap.org/ . Accessed July 7, 2009.
Spina bifida. March of Dimes website. Available at: http://www.modimes.org . Updated April 2006. Accessed July 7, 2009.
Last reviewed September 2009 by J. Thomas Megerian, MD, PhD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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