Spina Bifida is a birth defect which falls under the category of neural tube defect. It is a condition that arises when the spine and the spinal cord is not formed properly. Usually by the 28th week of conception the neural tube is formed. In babies with Spina Bifida, a portion of this neural tube either fails to develop or close properly.

Spina Bifida is a Latin word, which literally translates to ‘split spine’.

Causes, Symptoms and Treatment for Spina Bifida

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What are the different types of Spina Bifida?

Spina Bifida is one such condition that can range in a variety depending on the grade of defect, type of defect, size, location and also the complications. Few of the different forms of Spina Bifida are:

Spina Bifida occulta

This type of Spina Bifida is the mildest form of defect. Occulta translates to hidden. In this defect there is a small gap between one or more bones of the spine i.e, the vertebrae. Many of the people with Spina Bifida are not even aware that they have this defect unless it is detected by an imaging test done for other reasons unrelated to Spina Bifida.

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Meningocele

This type of defect is due to the formation of a sac filled with fluid that pushes itself out in between the vertebrae. This sac is formed due to the meninges (protective coverings) around the spinal cord. Since, the spinal cord is not presen in the sac it does not necessarily lead to nerve damage but can cause later complications.

Myelomeningocele

This is the most severe form of Spina Bifida where even the spinal cord is open. Here, the meninges along with the spinal nerves are pushed through this opening into a sac thus exposing the nerves and tissues. The baby is thus prone to life – threatening infections.

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What are the causes of Spina Bifida?

The causes for Spina Bifida are not quite definite. It is believed that environmental and genetic factors contribute to this type of defect. However, there are certain risk factors involved that include:

• Deficiency of folic acid in the mother’s body during pregnancy thus leading to development of neural tube defects.
• Uncontrolled diabetes among women
• Women who are obese are more likely to birth a child with Spina Bifida
• Spina Bifida is also more common among White and Hispanic babies and also girls.

What are the symptoms of Spina Bifida?

The symptoms of Spina Bifida vary depending on the type:

• In Spina Bifida occulta – There are typically no signs and symptoms since the spinal nerves are not harmed. There can however be certain indications such as abnormal tuft of hair or a small dimple or a birthmark on the newborn’s skin above the spinal defect.
• In meningocele – The sac poking over the skin can be visible.
• In myelomeningocele – The tissues and nerves are exposed and the baby is prone to several life – threatening infections.

When should you refer to a doctor?

Usually, if the baby is born with meningocele or myelomeningocele the doctors diagnose it before or right after birth.

In case of a baby born with Spina Bifida occulta, they carry on their lives with typically no symptoms.

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What are the treatments regarding Spina Bifida?

Treatment for Spina Bifida is surgery performed by neurosurgeons. Doctors can operate on the babies when they are just a few days old or also during the time they are still in the womb, this is what a fetal surgeon does. The treatment plan also varies depending on the type of Spina Bifida:

• If the baby has meningocele – In about 24 to 48 hours after birth, the surgeon will push the sac with the membrane around the spinnal cord back into its placce and close the opening.
• If the baby has myelomeningocele – In about 24 to 48 hours after birth, the surggeon will put the tissue and spinal cord back inside the baby’s body and then cover it with skin. In some cases, the surgeon may also put a hollow tube into the baby’s brain that is called a shunt. This shunt helps to prevent the water from collecting in the brain, the condition otherwise known as hhydrocephalus.

Sometimes the surgery is also done in the womb before the 26th week of pregnancy where the surgeon would go into the womb of the mother and sew the opening shut over the baby’s spinal cord. The advantage of this type of surgery is that, babies born are found to have fewer birth defects. This however is risky to the mother and the chances of pre-term delievery are increased.

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What are the complications regarding Spina Bifida?

• After the surgeries performed, the affected may need help with hips, feet or the spine and some may even require the need to replace the shunt in the brain.
• Around 20% – 50% of children with myelomeningocele also have a condition called progressive tethering. In this condition the spinal cord gets fastened to the spinal canal. As the child grows, the spinal cord is stretched and this causes problems with bowel, bladder or muscle.
• Some may require future surgeries to fix the problems caused by progressive tethering.
• Some may need crutches, wheel chairs or braces for their moving around.
• Some may even need a catherer installed to help fix their bladder problems.

Conclusion

Spina Bifida is a birth neural tube defect which is of different types – Spina Bifida occulta, meningocele, myelomeningocele.

Depending on the type of Spina Bifida is the severity, causes, complications and treatments. Of the types of Spina Bifida the most severe is myelomeningocele where the spinal cord along with the meninges is pushed into a sac thus exposing nerves and tissues to many life – threatening infections. Surgery is required to correct this defect.

Meningocele is another type where the meninges form a fluid filled sac and once again surgery is required to correct this defect. Spina Bifida occulta is the mildest form where there is a gap between the vertebrae and is typically asymptomatic.

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References

https://www.webmd.com/parenting/baby/spina-bifida#3-7

https://www.cdc.gov/ncbddd/spinabifida/facts.html#causes