Spina bifida is a congenital problem. So, it is the problem that occurs even before the birth of the child. The issue can reduce the quality of life of a child. You may have heard the doctors prescribing folic acid tablets to pregnant ladies. It is to avoid the neural defect. The problem can lead to the incomplete development of the vertebral column. So, it may not fully cover the spinal cord. It gets exposed to injuries and other complication. Spina bifida is a problem that can affect the intellectual as well as physical development. Therefore, serious condition needs your attention. The problem varies from mild to severe. Depending on the severity of the issue, people can expect varying symptoms.
When a person gets affected by the problem, they need proper care. You have different treatment options to overcome the problem. From surgery to the other treatment techniques can provide relief. Get comprehensive information about spina bifida by reading the article. It will help you understand the signs, the causes of the problem, and the ideal treatment option to manage the issue.
What Is Spina Bifida?
When the conception occurs, the embryo develops a neural tube. It is the primitive tissue structure that develops into the significant body parts like tissue, nerves, and bones. The neural tube also forms the human nervous system, spine, spinal column, and the bones that surround as well as protects the nerves. The spina bifida can cause defects in the neural tube during the embryo development can result in the improper development of the spinal column. So, the spine of the baby may not close completely. It can result in the exposure of the spinal column along several vertebrae.
Spina bifida is a Latin word that means a split spine. It can result in the formation of the sac at the back of the fetus. So, it can push out the spinal cord as well as membranes. The sac can contain membranes or meninges. It is a common birth-related issue that affects children in several countries around the world. Around 15% of the children born around the world suffer from the problem. The Caucasian race is more prone to the problem compared to other races.
Types Of Spina Bifida
You can classify the problem based on the severity. It is divided into four major types.
It is the mildest form of the problem. When patients have a particular type of spina bifida, they may not see any visible neurological signs or symptoms. You can only find a small dimple, birthmark or tuft of hair in the region that has a spinal defect. In most cases, a person may not know he suffers from the issue. A test for another condition reveals the problem by accident.
Closed Neural Tube Defects
It is slightly more problematic than the first type. You can experience potential defects with the closed neural tube defects. In most cases, it can occur in the spinal bone, its fat or meninges. So, the problem can cause little or no symptoms. People find partial paralysis due to the issue. The urinary or bowel incontinence can also occur due to the problem.
The least common form of spina bifida occurs due to the small development issue. With the problem, the spinal cord can develop normally. But, the developmental issue occurs at the protective membrane around the spinal cord (meninges). It can lead to the meninges pushing through the vertebrae opening. You need surgical intervention to remove the membrane. A good surgeon can remove the membranes without causing any damage to the nerve pathways in the spinal region.
It is the most severe form that has severe complications. When a person suffers from a particular type, the exposure of the spinal cord occurs. So, it can result in the partial or complete paralysis of the body. The paralysis occurs just below the opening.
Symptoms Of Spina Bifida
The mild forms of the spina bifida may develop the following signs or symptoms. So, the infant born with neural defects can suffer from the following:
- Weakness in the legs
- Lack of sensation in the skin
- Paralysis in the lower part of the body
- Bowel incontinence
- Urinary incontinence
- Infection prone nervous system
- The buildup of CSF (Cerebrospinal Fluid)
Symptoms Of Myelomeningocele
The severe form of the spina bifida has different symptoms. The condition can cause unusual cerebral fluid buildup in the bran. So, it can trigger a range of issues like:
The ability of a person to think, learn, judge, become aware of surroundings, etc. are known as cognition. The neural tube problems can have a negative impact on a child’s brain development. So, it leads to the improper frontal part development. It results in cognitive issues.
People suffering from the issue have only normal intelligence. But, spina bifida can trigger learning difficulties. So, it can pose problems with the reading, problem-solving, attention span, grasping concepts, making plans, and understanding the spoken language
Type 2 Arnold-Chiari Malformation
It involves the abnormal brain development of the cerebellum. It can lead to the accumulation of CSF known as hydrocephalus. So, it can affect the physical coordination and language processing.
The physical and visual coordination becomes difficult with the severe form of spina bifida. So, it makes it difficult even to perform simple chores like tying shoelaces or doing up the buttons.
The severe case of spina bifida has some degree of paralysis. They can experience weakness in the legs. The partial or complete paralysis requires leg braces or wheelchair to improve mobility. The lack of exercise can result in weak, misshapen or dislocated bones. So, the patients need to exercise their lower limbs to avoid the condition.
The people suffering from neural defects have a high risk of getting affected by meningitis. It can have life-threatening complications.
The patients suffering from spina bifida can encounter other health issues like:
- Bowel incontinence
- Latex Allergies
- Urinary Incontinence
- Gastrointestinal Problems
- Skin Problems
Causes Of Spina Bifida
So, what exactly causes the problem? The proper answer remains quite unclear to the scientists. But, the combination of nutritional, environmental, genetic/inherited factors can influence getting the problem. Spina bifida can result in not closing of the spine of the fetus. So, the main causes of getting the problem are:
Folic Acid Deficiency
The efficiency of folic acid during the pregnancy can result in the unborn child developing the problem. So, in many countries, the gynecologists prescribe taking the folic acid at least two months before the conception and for three months after getting pregnant. The women in the reproductive age need to consume folic acid to avoid any birth-related complication to the child. It is established that consuming folic acid has reduced the birth with neural defects around the world.
The low intake of nutrients like iron, plant protein, niacin, and magnesium before conception can result in high neural birth defects. So, you have high chances of getting the problem with nutritional deficiency.
People with a family history neural defect at birth have a high possibility of another birth with the same problem. So, an infant born with the issue has a high risk of having a sibling with the same condition.
Some medication used to treat health conditions like bipolar disorder or epilepsy can result in babies with birth defects. So, drugs like valproate can result in babies with congenital birth defects.
Uncontrolled diabetes during pregnancy can result in a child with neural defects. Therefore, expectant mothers with diabetes are at risk of delivering babies with spina bifida.
An expectant mother who has BMI (body mass index) above thirty are at risk of having babies with neural defects.
Diagnosis Of Spina Bifida
How can you detect the presence of the neural defect in a child? You need professional medical assistance to detect the issue with precision. Therefore, pregnant ladies need to talk to their obstetrician to let them know about the concerns. The doctor can perform the following tests to detect the issue conclusively:
In most cases, your doctor can detect the issue with the ultrasound scanning. It provides the visual of the fetus. It also checks for the other issues in the child before it is born. If your doctor suspects any problem, then more tests can confirm the issue.
MSAFP (Maternal Serum Alpha-Fetoprotein) Test
Testing for spina bifida before the birth of a child cannot provide 100% accurate results. MSAFP is one of the tests that can indicate the presence of neural defects. It assesses for the AFP (alpha-fetoprotein). Therefore, evaluating the protein produced by the fetus provides a clear idea of the problem. In normal cases, the AFP does not enter the expectant mother’s bloodstream. But, when AP enters the mother’s bloodstream, it indicates the child has an underdeveloped brain, incomplete skull or spina bifida. The test is not as accurate as the high levels of AFP can occur during other scenarios like:
- The pregnancy has more than one fetus
- Error in calculating in the gestational age
Amniocentesis is another test prescribed by the doctor to detect the issues with the unborn baby. During the test, the doctor takes a sample of the amniotic fluid from the sac. It is sent to the lab for testing for the AFP levels. The high levels of AFP in the amniotic fluid surrounding the baby indicates the presence of neural tube defects. For high levels of AFP, the doctor can suggest other tests like the triple screen or quad (quadruple) screen confirm the diagnosis.
Treatment For Spina Bifida
The treatment option depends on several factors. It mainly depends on the symptoms the affected person experiences and the severity of it. In most cases, the treatment may vary like:
The invasive procedure gets adopted by the doctor to relieve the possible signs to an extent. The different invasive option available are:
Spine Repairing Surgery
The doctor can perform the surgery on the infant two days after birth. During the surgery, the doctor replaces the exposed nerves, tissue, and the spinal cord back into the body. The doctor also closes the gap present in the vertebrae. The gap on the spinal cord gets sealed with the skin and muscle. At times, the child can suffer issues due to bone development. The problems like dislocated joints or scoliosis get corrected with further surgery or back brace.
As the name suggests, the surgery can repair the issues of the spinal cord of the fetus inside the womb. The surgery opted at the 19th to 25th week of gestation can avoid the problem of spina bifida from worsening after the birth. The surgeon opens the womb to repair the spinal cord problems.
The doctor can suggest Cesarean form of birth instead of normal delivery. It is ideal for infants suffering from neural defects. The C-section makes it a safer option for kids from getting their nerves exposed.
The building up of cerebrospinal fluid in the brain can happen. It is one of the side effects of the surgery to repair the neural defect damage. So, the surgeon implants a shunt or thin tube in the brain of the baby. It can drain away from the excess fluid. In most cases, a permanent shunt gets placed to drain the fluid into the abdomen area.
The diverse therapies can aid the patients to lead a better life without other’s help. The different therapies that can help the sufferers are:
People affected by spina bifida have a weak lower body. So, physical therapy aims to make the individual become independent. It can strengthen the lower limb. Your doctor can also suggest braces to enhance the strength of the muscles.
In severe cases, the complication can result in total paralysis. In such cases, the patients need a wheelchair to improve their mobility. It is better to opt the manual wheelchair compared to the electric ones. it can enhance the upper-body strength. So, you can ensure your general fitness with the use of manual ones. Apart from the wheelchair, the following devices can help the patients:
- Specialized software and computers to aid with the learning disabilities.
- Leg braces to assist people who suffer from the partial paralysis.
Occupational therapy can provide self-confidence and enhance the self-esteem to the kids. The children who find it difficult to perform everyday activities can benefit from occupational therapy. So, they can easily complete activities like getting dressed or perform other tasks.
The people suffering from spina bifida can also suffer from urinary and bowel incontinence. So, the different treatment options available can overcome the problem with ease.
Treatment For Urinary Incontinence
You need to get the medical help from a urologist to get ideal treatment after the proper assessment. So, the treatment techniques available are:
- Botox injection
- CIC (Clean Intermittent Catheterization)
- Artificial Urinary Sphincter (AUS)
- Mitrofanoff Procedure
Treatment For Bowel Incontinence
The doctor can suggest a special diet to overcome the problem. In some cases, other techniques can also provide relief. The following options depending on the severity of the problem helps people manage their everyday activities.
- Anal Plugs
- Antegrade Continence Enema (ACE)
- Ileostomy or Colostomy
A child with the spina bifida problems needs special care. The treatment offered by a panel of specialists like urologist, orthopedist, neurosurgeon, and a pediatrician can help them live a happy life.
Preventing Spina Bifida
The actual cause of spina bifida remains a mystery to the doctors. Therefore, the best method to prevent the issue from affecting you can puzzle even the doctors. But, you can adopt some steps to ensure the baby does not get affected by the issue.
Take Folic Acid
Pregnant women need to consume at least 400mcg of folic acid daily. It is the key nutrient for the baby’s correct development. The green leafy vegetables also contain a high amount of folic acid. So, you include the following food item that contains a high amount of folic acid like:
- Egg Yolks
- Dark Green Leafy Vegetables
- Fortified Cereal Products
Women trying to get pregnant need to ensure they have an adequate amount of folic acid to prevent the issue.
Test To Detect Neural Defects
You can undergo the tests to detect the neural defect in the fetus. It also finds other issues that the child may face in the womb. It helps the doctor take necessary action to reduce the risk or prevent the problem from escalating. Women who have given birth to a child with neural defects need to take extra folic acid to prevent the issue from repeating again.
The tremendous improvement in the medical field makes it possible for children suffering from spina bifida to survive into adulthood. It is also now possible for the affected people to live independently without the help of others. The children suffering from a mild form of the problem can have normal intelligence. They can walk, talk, and live a life like normal people. They only need support for some of the health issues like incontinence. With good support, the affected people can successful life. So, getting medical support at the right time to deal with the problem properly.
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