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Spina bifida

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Overview of spina bifida

Spina bifida, which literally means “split spine”, is a birth defect that involves the incomplete development of the spinal cord. In normal cases the neural tube closes within a month of conception but in same cases the spine (vertebrae) does not form properly around the spinal cord. Spina bifida is a neural tube defect that affects how the skin on the back looks. While in most cases it does not give any problem in severe cases, there can be difficulty in walking or doing daily activities. 


Symptoms of spina bifida

Generally mild cases in a child do not show any symptom and will not prove to be problematic. Mild cases of spina bifida will only result in a dimple or a birthmark for the child and in most cases people would not even know they have these conditions.

Other symptoms in such cases are: 

  • An abnormal tuft of hair
  • A collection of fat
  • Skin discoloration 
However, severity of spina bifida may increase to a condition called meningocele. A rare form of spina bifida in such cases the protective membranes around the spinal cord push out through the opening in the vertebrae. Such cases are easily treated through a surgery and do not cause any issues.

The other type of spina bifida is myelomeningocele in which the both the baby's spinal cord and membranes protrude at birth forming a sac on the baby’s back. This condition can be life threatening and needs immediate medical attention. 

Other symptoms for severe cases of spina bifida include muscle weakness, bowel and bladder problems, deformed feet, and seizures in case fluids buildup in the brain(hydrocephalus).

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Causes of spina bifida

There is no exact known cause for this disease. Researchers believe it is a genetic disorder and can also be due environmental factors.


Risk factors for spina bifida

The risk of spina bifida is higher in western countries and it seems to affect whites and Hispanics more than others. Also risks increases if there are cases of spina bifida in the family, mainly the father or mother. However, a direct linkage has not been established between family history and neural tube defects. 

Researchers also believe folate (vitamin B-9) deficiency can increase the chance of a baby having spina bifida. On the other hand it is believed that taking anti-seizure medications, such as valproic acid during pregnancy can also lead to neural defects.

Other factors include pre-pregnancy obesity and hyperthermia during pregnancy


Diagnosis of spina bifida

There is no comprehensive method to diagnose neural tube defects. During pregnancy there are chances of detecting spina bifida by testing the mother's blood (AFP screening). If the blood tests show high levels of maternal serum alpha-fetoprotein (MSAFP) a doctor would normally ask for an ultrasound of the fetal spine to be carried out. A doctor may also ask for mother's amniotic fluid (to test for alpha-fetoprotein and acetylcholinesterase) to be carried out.  

However, these tests are not conclusive and there are instances where despite abnormalities during pregnancy, the child, when delivered, have been normal.


Treatment of spina bifida

Most cases of spina bifida do not need any treatment. Meningomyelocele cases need surgery and are usually done soon after child birth. Similarly a child with meningocele also needs surgery, and in most cases such surgeries are successful. 

While there is no known cure for nerve damage caused by spina bifida, operations by pediatric neurosurgeons have been able to resolve most of the issues. For cases with hydrocephalus a shunt may needed to drain out the excess water from the brain. With the advances in medicine if spina bifida is detected during pregnancy, doctors can nowadays perform an open or minimally-invasive fetal surgery.

A child with spina bifida may need ongoing treatment even after a surgery. A child will need to work with physical therapists or occupational therapists and start exercising. There may be cases of bladder or bowel problems and these issues will have to be fixed subsequently. In some cases treatment of spina bifida may include multi-disciplinary fields of medicines and doctors.


Prevention of spina bifida

It is advisable that pregnant women take folic acid before and during the first three months of pregnancy. This is generally 400 mcg (0.4 mg) of folic acid each day during the pregnancy. Several foods, including bread, pasta, rice and breakfast cereals also contain folic acid and are considered good. 

It is also advisable to eat healthy with plenty of beans, fruits and juices, egg yolks, and green vegetables, such as broccoli and spinach.

Written by: Healthplus24 team
Date last updated: July 25, 2013

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