Spina Bifida Explained

The spine is a complex structure and one of the most important elements of the human body. Damage to it has the potential to cause serious complications, including loss of mobility and decreased sensation.

However, not all spinal conditions are caused by accidents or injury. There are a range of disorders that range from curvature of the spine and conditions such as kyphosis and scoliosis, to congenital conditions such as spina bifida.

Each of these bring their own challenges. Here we take a closer look at spina bifida.

What is Spina Bifida?

The literal translation of spina bifida is ‘split spine’. It is a condition that occurs during development in the womb and is present at birth and happens when the neural tube doesn’t form properly or fails to close.

No one is certain why spina bifida occurs and there may be a mix of different physical, environmental and genetic factors that play a role. There are different kinds of spina bifida and treatment and prognosis will generally depend on the severity of the condition.

Different Types of Spina Bifida

• Occult Spinal Dysraphism (OSD): The spinal cord doesn’t grow the right way. The immediate physical sign of this is a dimple in the lower back, although this can be present even if spina bifida is not. Doctors will carry out tests to confirm the diagnosis.
  
• Spina Bifida Occulta: This could include conditions such as a tethered cord, where the spinal column is attached to the bone, preventing it growing properly. Spina bifida occulta is often not diagnosed immediately and may only become problematic as a child grows into adulthood.
  
• Meningocele: The spinal cord protrudes through the spinal column a bit like a sac and this can cause a range of often minor disabilities.
  
• Myelomeningocele: This is also known as spina bifida cystica and can cause nerve damage leading to disability. Fluid on the brain causing swelling and pressure might be a particular problem, a condition that can lead to hydrocephalus.

Spina Bifida Symptoms

The different types of spina bifida mean that symptoms can vary a lot from child to child. In spina bifida occulta, for example, there may be no outward signs until someone gets much older. More severe symptoms could include mobility issues and problems with controlling the bladder and bowels.

• There may be difficulty walking and moving in general because the nerves are not operating properly.
  
• In myelomeningocele, the brainstem may be positioned lower than normal and elongated.
  
• Physical signs in a baby might include sleepiness, vomiting, and trouble feeding.
  
• A tethered spinal cord means that a patient may exhibit loss of muscle movement and loss of control of the bladder or bowels as they begin to grow.
  
• Children who have spina bifida are also more likely to have a latex allergy.

Causes of Spina Bifida

Risk factors associated with spina bifida are not entirely clear and a range of environmental and genetic factors may be at play. ]

A mother may be more likely to have a pregnancy involving spina bifida if they have:

• history of it in the family
• folate or vitamin B9 deficiency
• diabetes or are obese
• been taking certain forms of drugs such as anti-convulsant medication
• an increased body temperature at the early stages of pregnancy

Diagnosing Spina Bifida

Meningocele and myelomeningocele are generally diagnosed at birth but conditions such as spina bifida occulta can take many years before they are noticed.

Many instances of spina bifida will elicit only minor symptoms and much will depend on the location of the neural defect as well its size.

During pregnancy there are a number of diagnostic tools used to check for spina bifida:

• A test to see if the mother’s blood contains the protein AFP.
• Ultrasound tests may also reveal if a baby has certain types of spina bifida.
• Amniocentesis uses a needle to take a small amount of amniotic fluid. This is only used if the first two tests produce inconclusive results and spina bifida is still suspected.

Treatment of Spina Bifida

Treatment of spina bifida will depend on the type and the severity of the symptoms. Babies can be operated on a couple of days after birth but this is usually only resorted to in conditions such as meningocele and myelomeningocele and particularly in cases where the spinal cord is exposed.

Some symptoms such as tethering can be operated on at a later date when the child is older. Much of the treatment of children with spina bifida, however, is focused on helping them live with their condition.

That can include learning to use braces and crutches or wheelchairs as well as coping with any bladder and bowel problems.

Spina Bifida Support

Spina bifida a relatively common condition in the US but the more severe forms are quite rare. Organisations such as the Spina Bifida Association can provide plenty of support to individuals with spina bifida and their families.