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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“At Southwest Scoliosis and Spine Institute, we see adults and children in pain. Consequently, we use our expertise and experience to make a difference in improving their lives.”
Richard Hostin, MD

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.

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 than the average, there are chances 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.

Bottomline 

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.

We’re here to help STOP THE PAIN
If you or your loved one suffers from back pain from a spinal condition, we can help. Call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment today.