Spina Bifida
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Spina BifidaWhat is spina bifida? Spina bifida is a birth defect in which the spinal column does not close properly during prenatal development. In the most extreme cases, this may cause a portion of the spinal cord and its surrounding membranes to be exposed through the opening in the spinal column. Spina bifida usually develops during the first month of pregnancy. The three types of spina bifida are classified according to their severity. The most common, spina bifida occulta, is the least serious. In spina bifida occulta, at least one vertebra in the back is not fully closed, but it is still covered by a layer of skin. In fact, because spina bifida occulta often presents no symptoms, many people are unaware that they have the condition. In meningocele, a second type of spina bifida, there is an opening in the spinal column through which the membranes surrounding the spinal cord (the meninges) protrude. Meningocele is relatively easy to treat because the spinal cord itself is not damaged. The most serious form of spina bifida is myelomeningocele. In myelomeningocele, the opening in the spinal column is so severe that the spinal cord itself protrudes out of the infant’s back. Because of the nerve damage that it can cause, myelomeningocele often leads to other physical problems. Complete or partial paralysis below the defective vertebrae is not uncommon. Because spina bifida is often accompanied by hydrocephalus, in which fluid collects in the brain, brain damage may also occur. How does spina bifida occur? The cause of spina bifida has not been definitively identified, although certain factors do seem to increase infants’ risk of developing the defect. A lack of folic acid in the mother’s diet has been associated with the development of neural tube defects, including spina bifida. In addition, a family history of the condition seems to up a baby’s chances of developing spina bifida—if one child is born with spina bifida, future children are more likely to be born with it as well. There is also speculation that spina bifida may be caused by a virus, because children born in colder months are diagnosed with it more often than are those born in warmer months. Finally, environmental exposure to radiation is thought to be a cause of some spina bifida cases. How is spina bifida treated? Spina bifida treatment is used to minimize the complications that can be caused by the condition, including infection and brain damage. In most cases, surgery can successfully reverse the physical defect, although neurological damage is usually permanent. Surgical repair of meningocele and myelomeningocele is usually performed soon after birth, although in some cases it may be postponed if the child needs to gain strength before surgery can be performed safely. Special care is needed until surgery can be performed, because touching the exposed spinal cord can cause additional damage. Hospital staff may need to use supportive devices and special techniques to protect the baby when it is handled. Antibiotics are often used to limit infection and to lower the risk of meningitis. Some children will need to have a catheter inserted (have a special tube placed in the bladder through the urethra for the elimination of urine), and infants with hydrocephalus may need surgical shunting, in which a special opening is created to relieve pressure in the brain. In addition to physical treatments, patients and their families may elect to receive counseling and group support to deal with the effects of spina bifida. Research is underway to allow surgery to be performed prior to birth (“in utero”). Researchers hope that by surgically correctly spina bifida before birth, side effects may be less severe. |
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