Spina bifida


Spina bifida

Description, Causes and Risk Factors:

Alternative Name: Hydrocele spinalis, schistorrhachis.

Spina bifida is a Latin term meaning 'open spine.' Medically it refers to a birth defect where the spine does not form completely. The spina bifida defect may leave several vertebrae deformed in such a way as to expose the spinal cord. Although spina bifida is originally a skeletal defect, there are a significant number of directly related conditions which precipitate from the defect in the spine. People who are born with spina bifida frequently have one or more related defects.

Spina bifida is considered a defect in the neural tube (NTD). This neural tube defect occurs during the first four weeks of pregnancy, before a woman will be tested to confirm pregnancy. It is the early development of the defect which makes it both hard to treat and hard to detect prior to ultrasound tests.

By the time the first ultrasound is done at about 18 weeks. By this time, permanent damage is already done if a child has a major spina bifida type. Although spina bifida can be detected at the first ultrasound, the extent of the damage cannot be determined until the child is born.

Although the cause is unknown, a combination of genetic and environmental factors might be involved. Once a woman has a child with spina bifida, her chance of having another child with spina bifida is one in 20. Some babies are born with spina bifida because their mothers did not have enough folic acid (B vitamin) in their bodies early in the pregnancy. Many women do not know they are pregnant when this happens.

Types may include:

    Myelomeningocele is a common type of spina bifida. The layers that cover the spinal cord (meninges) and nerves come out through an opening in the baby's back. There is nerve damage that can cause different types of problems. These include control of the bladder and intestine (not knowing when to go to the bathroom) and problems walking.

  • Meningocele: In meningocele, a baby is born with a sac protruding from an opening in the spinal column. The condition differs from myelomeningocele in that the sac does not contain the spinal cord and fewer nerves are affected. Babies need surgery shortly after birth to repair the affected area. Most babies born with meningocele grow up without complications. Some have minor disabilities.

  • Occult Spinal Dysraphism (OSD): Infants with this have a dimple in their lower back. Because most babies with dimples do not have OSD, a doctor has to check using special tools and tests to be sure. Other signs are red marks, tufts of hair or small lumps. In OSD, the spinal cord may not grow the right way and can cause serious problems as a child grows up. Infants who might have OSD should be seen by a doctor, who will recommend tests.

  • Spina bifida occulta: In spina bifida occulta, the bones around a baby's spinal cord fail to develop normally. The nerves of the spinal cord usually are normal, as is the skin on the back. Sometimes, however, there will be a dimple, hair patch or red discoloration on the skin over the affected area. Babies born with spina bifida occulta usually don't experience complications. Sometimes, however, patients experience problems such as tethered spinal cords.

Symptoms:

Children and young adults with spina bifida can have mental and social problems. They also can have problems with walking and getting around or going to the bathroom, latex allergy, obesity, skin breakdown, gastrointestinal disorders, learning disabilities, depression, tendonitis and sexual issues.

Diagnosis:

The maternal serum triple test uses a blood sample from the mother to screen for fetal abnormalities, including neural tube defects. When tests show elevated levels of alpha-fetoprotein (AFP), neural tube defects such as spina bifida are more likely. A high-resolution fetal ultrasound may then be done to try to determine whether the fetus has any visible abnormalities. Usually fetal ultrasounds can only detect signs of severe spina bifida (manifesta).

Amniocentesis usually is also done when the maternal serum triple test indicates a high level of AFP. Amniocentesis allows health professionals to measure the levels of substances in the amniotic fluid of the fetus. Because abnormalities related to spina bifida are not always revealed by fetal ultrasound, an amniocentesis may be done even without first having an ultrasound or if an ultrasound is done and appears normal.

Spina bifida is usually diagnosed when amniocentesis results confirm heightened levels of AFP and the enzyme acetylcholinesterase (ACH), and the ultrasound shows fetal abnormalities in the spine that are specific to spina bifida.

After birth, spina bifida may be diagnosed by the appearance of the back. An X-ray, MRI, or CT scan may be done to evaluate suspected spina bifida.

Treatment:

No two people with spina bifida are exactly alike. Health issues and treatments for people with spina bifida will be different for each person. Surgery may be done to repair the spinal defect or to correct complications such as hydrocephalus. Physical therapy, braces, and other treatments may be necessary to help children who have problems resulting from nerve damage.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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