SPINA BIFIDA

Spina Bifida is a birth defect that in some cases causes the spinal cord to incorrectly form outside of the baby’s body on the back.

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Spina Bifida

Spina bifida is a birth defect that occurs when the spine and spinal cord are malformed. In babies with spina bifida, they have a type of neural tube defect (NTD), a section of the neural tube that does not develop properly. This condition leads to problems in the spinal cord, nerves, and in bones of the spine. Depending on the severity, this condition can cause mild to severe physical and intellectual disabilities. The severity depends on the defect type, size, location, and complications. Scoliosis often occurs as the child matures.

If necessary, early treatment for spina bifida may involve surgery. However, treatment like that may not always completely solve the problem.

The Three Most Common Types of Spina Bifida:

Occulta

Occulta is a Latin word that means hidden. This type is the least severe and most common. In this condition, there is a small gap in one or more bones in the spine but no opening or sac on the back. This type usually does not cause any complications or disabilities. That is why many people with spina bifida occulta do not even know they have it.

Meningocele

It is a rare type of spina bifida. This condition looks like a sac of spinal fluid emanating through an opening in the spine. In this type, no nerves are affected, and the spinal cord is not in the sac either. Babies with meningocele may have some minor complications with functioning related to the bladder and bowels.

Questions and Answers

What is Spina Bifida?

Spina bifida is a congenital condition where the neural tube, which eventually develops into the spinal cord, does not close properly during fetal development. This incomplete closure can lead to varying degrees of spinal cord and nerve damage. The severity of spina bifida can range from mild cases with minimal symptoms to more severe forms that cause significant disabilities.

What are the symptoms of Spina Bifida?

The symptoms of spina bifida can vary depending on the type and severity of the condition. Common symptoms may include an opening or lesion on the back, weakness or paralysis in the legs, bowel and bladder problems, orthopedic issues such as clubfoot or scoliosis, hydrocephalus (buildup of fluid in the brain), and cognitive or learning difficulties. It’s important to note that not all individuals with spina bifida experience the same symptoms, and the severity can vary widely.

How is Spina Bifida Treated?

Treatment for spina bifida typically involves a multidisciplinary approach to address the various aspects of the condition. The specific treatment plan depends on the severity and symptoms of the individual. It may include surgery to repair the spinal defect soon after birth, management of associated complications such as hydrocephalus or orthopedic issues, physical therapy to improve mobility and strength, assistive devices, and ongoing medical care to monitor and address any health concerns. Early intervention and comprehensive care can greatly improve outcomes and quality of life for individuals with spina bifida.

Myelomeningocele

Myelomeningocele, aka open spina bifida, is the most severe type. In most cases, when people talk about this condition, they are referring to this type. In this condition, a sac of fluid comes through an opening in the back of the baby. The parts of the spinal cord and nerves in this sack are damaged. This type is likely to cause moderate to severe disabilities, such as life-threatening infections, paralysis, bladder, and bowel dysfunction.

Signs and Symptoms

Spina Bifida Occulta

In this condition, usually, there are no signs or symptoms since the spinal nerves are not involved. However, there might be several signs on the skin of the baby right above the spinal problem. For example a tuft of hair, a tiny dimple, or a birthmark. Doctors can discover any underlying spinal cord issue in a newborn with MRI or spinal ultrasound.

Meningocele

  • This type may come up with complications related to bowel and bladder function.

Myelomeningocele

  • Here, the spinal canal stays open in the lower or middle back with some visible vertebrae.
  • At birth, membranes, spinal cord, or nerves will be found in a sac on the back of the baby.
  • Even though sometimes skin covers the sac, tissues, and nerves are usually exposed.

Associated Complications 

Spina bifida can cause various symptoms and problems depending on the severity. Factors that determine the complications are:

  • The severity and location of the NTD
  • Whether the skin covers the affected area
  • Which spinal nerves have come out of the affected section of the spinal cord

The range of associated complications may seem quite overwhelming. But the thing is, not all children with spina bifida experience all of these. Moreover, in some cases, they have none of these complications at all.

Our Doctors can Treat Many Associated Complications:

  • Walking and mobility problems
  • Orthopedic complications.
  • Bowel and bladder problems.
  • Accumulation of fluid in the brain (hydrocephalus).
  • Sleep-disordered breathing.
  • Shunt malfunction.
  • Chiari malformation type II.
  • Meningitis
  • Tethered spinal cord.
  • Latex allergy, etc

Diagnosis

Doctors can diagnose Spina bifida during pregnancy or after the baby is born. The occulta type might stay completely undiagnosed until late childhood or adulthood, or might never be diagnosed.

During pregnancy, screening tests help check for spina bifida and detect other birth defects. Feel free to talk to our doctors if you have any questions or concerns regarding this prenatal testing.

Testing

AFP – AFP stands for alpha-fetoprotein. It is a protein that the unborn baby produces. This simple blood test helps measure how much AFP the baby has passed into the mother’s bloodstream. If there is a high level of AFP, the baby likely has spina bifida.

Ultrasound– Through ultrasound, doctors can see if the baby has any spinal problems.

Amniocentesis– Doctors will take a small sample of the amniotic fluid from the womb surrounding the baby. If there is a higher level of AFP in the fluid, then there is a chance the baby has a spinal problem.

After The Baby Is Born 

In several cases, spina bifida may stay undiagnosed until the baby is born. The common signs can be a dimple or a patch of hair on the baby’s back. Doctors use an X-ray, MRI, or CT to get a better image of the spine.

Treatments of Spina Bifida

Since there are different types of spina bifida, not all born with this condition have similar needs. Hence, treatment will be different in each case depending on the severity of the condition. Children with myelomeningocele and meningocele will need more serious treatments than those with the Occulta type.

The Causes and Risk Factors 

Even though genetics, nutrition, and the environment play a crucial role in causing spina bifida, not all causes are clear. The condition is more common among Hispanics and white people. Also, research reports that females are affected more often than males. It is not clear why spina bifida occurs. But, doctors and researchers have identified some risk factors:

Folate Deficiency: Folate (vitamin B-9) is vital in the development of a healthy baby. While this is the natural form, the synthetic form called folic acid is found in supplements and fortified foods. A folate deficiency is a major risk factor in causing spina bifida.

Diabetes: Women with diabetes have a higher risk of having a baby with spina bifida.

Obesity: Pre-pregnancy obesity has an increased risk of birth defects.

Family history: Parents who have already had one child with a neural tube defect have a higher chance of having another baby with a similar defect. However, many babies with the condition are born to parents with no known family history of Spina Bifida.

Some Medications: When administered during pregnancy, anti-seizure medicines such as valproic acid tend to cause neural tube defects. Compounds like these prevent the body from using folate and folic acid.

Increased body temperature: Increased body temperature (hyperthermia), especially in the early weeks of pregnancy, increases the risk of spina bifida. Increases in core body temperature because of fever or having a sauna or hot tub increase the risk of spina bifida.

Preventive Measures

There are ways to reduce the risk of having a baby with spina bifida. Women can follow these preventive tips both before and during pregnancy.

  • Doctors recommend taking 400 micrograms (mcg) of folic acid every day. Moreover, if you have already had a baby with spina bifida, you may benefit from taking a higher dose of folic acid both before and during early pregnancy. Talk to your doctor to know what is best for you and your baby.
  • If you are already taking or about to take any prescription and over-the-counter drugs, vitamins, dietary supplements, or herbal supplements, discuss that with your doctor.
  • If you have diabetes or obesity, ensure it is under control before you get pregnant.
  • Avoid anything (hot tub or sauna) that increases your core body temperature or overheats your body.
  • Treat any fever with Tylenol® (store-brand acetaminophen).

Remember that Spina bifida occurs in the first few weeks of pregnancy, often even before you know you are pregnant. Folic acid may not guarantee that a woman will have a healthy pregnancy. But, taking folic acid can reduce the chance of a woman getting pregnant with a baby with this condition. Doctors always recommend that all women planning to become pregnant take 400 mcg of folic acid daily.

Spina Bifida Statistics:

Prevalence in the United States:

  • Approximately 1,427 babies are born with spina bifida each year, or 1 in every 2,758 births.
  • Hispanic women have the highest rate, followed by non-Hispanic Black women and non-Hispanic white women.

Globally:

  • Estimated 8.5 per 10,000 live births worldwide.
  • Varies significantly by region and country.

Types & Severity:

  • Myelomeningocele (MMC): Most severe, with the spinal cord exposed.
  • Meningocele: Sac containing meninges (membranes) but not spinal cord.
  • Occult spina bifida (OSB): Mildest form, with hidden neural tube defect.

Severity distribution:

  • MMC: Roughly 80% of cases.
  • Meningocele: Around 15%.
  • OSB: 5%.

Impact:

  • Physical challenges: Varies depending on severity and type. Can include paralysis, bowel and bladder issues, hydrocephalus (water on the brain), learning disabilities, and other complications.
  • Lifespan: Average lifespan for individuals with spina bifida is increasing, but generally lower than the general population.
  • Economic burden: Significant costs associated with healthcare, mobility aids, and other needs.

Additional Statistics:

  • Folic acid fortification: Has significantly reduced spina bifida prevalence since implemented in many countries.
  • Early diagnosis and intervention: Improves outcomes and quality of life for individuals with spina bifida.
  • Support resources: Numerous organizations provide information, advocacy, and support for individuals and families affected by spina bifida.

Sources:

Bottom Line 

If you are wondering how it would be for a child to live with Spina Bifida, it depends on how severe the condition is. While some may have little to no disability, others may have limited mobility, function, or sometimes even paralysis. However, with appropriate medical attention and care, most children affected by this condition can lead productive and fulfilling lives. And that’s why you should choose the Southwest Scoliosis and Spine Institute for your child. Doctors Richard Hostin, MDDevesh Ramnath, MDIshaq Syed, MDShyam Kishan, MD, and Kathryn Wiesman, MD, have many years of training and experience in Spine and Back Pain for kids, adolescents, young adults, and seniors, and can help people of all ages get back to living the life they love.

The following are just a few of the many reasons why patients might choose the Southwest Scoliosis and Spine Institute.
  • Expertise in the spine: The team of specialists at Southwest Scoliosis and Spine Institute is recognized as the very best.  They specialize in the diagnosis and treatment of spinal conditions, ensuring the best possible care for their patients.
  • Cutting-edge technology: Our practice uses the latest technology and techniques to diagnose and treat a wide range of conditions.  In addition, we use minimally invasive procedures that reduce pain and promote faster recovery.
  • Comprehensive care: Our practice offers a full range of services, from diagnostic imaging and physical therapy to surgery.  We ensure that patients receive complete, seamless care for their spinal conditions.
  • Dedicated facilities: Southwest Scoliosis and Spine Institute is dedicated to providing patients with a safe and comfortable environment.

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Spina Bifida Association: Spina Bifida

 

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