Spina bifida picture

What is Spina Bifida? | CDC

• Types of Spina Bifida
• Diagnosis
• Treatments

• Causes
• Living with Spina Bifida

Spina bifida is a condition that affects the spine and is usually apparent at birth. It is a type of neural tube defect (NTD).

Spina bifida can happen anywhere along the spine if the neural tube does not close all the way. When the neural tube doesn’t close all the way, the backbone that protects the spinal cord doesn’t form and close as it should. This often results in damage to the spinal cord and nerves.

Spina bifida might cause physical and intellectual disabilities that range from mild to severe. The severity depends on:

• The size and location of the opening in the spine.
• Whether part of the spinal cord and nerves are affected.

Types of Spina Bifida

The three most common types of spina bifida are:

Myelomeningocele (sounds like: my-low-ma-nin-jo-seal; hear how “myelomeningocele” soundsexternal icon)
When people talk about spina bifida, most often they are referring to myelomeningocele. Myelomeningocele is the most serious type of spina bifida. With this condition, a sac of fluid comes through an opening in the baby’s back. Part of the spinal cord and nerves are in this sac and are damaged. This type of spina bifida causes moderate to severe disabilities, such as problems affecting how the person goes to the bathroom, loss of feeling in the person’s legs or feet, and not being able to move the legs.

Meningocele (sounds like: ma-nin-jo-seal; hear how “meningocele” soundsexternal icon)
Another type of spina bifida is meningocele. With meningocele a sac of fluid comes through an opening in the baby’s back. But, the spinal cord is not in this sac. There is usually little or no nerve damage. This type of spina bifida can cause minor disabilities.

Spina Bifida Occulta (sounds like: o-cult-tuh; hear how “occulta” soundsexternal icon)
Spina bifida occulta is the mildest type of spina bifida. It is sometimes called “hidden” spina bifida. With it, there is a small gap in the spine, but no opening or sac on the back. The spinal cord and the nerves usually are normal. Many times, spina bifida occulta is not discovered until late childhood or adulthood. This type of spina bifida usually does not cause any disabilities.

Diagnosis

Spina bifida can be diagnosed during pregnancy or after the baby is born. Spina bifida occulta might not be diagnosed until late childhood or adulthood, or might never be diagnosed.

During Pregnancy

During pregnancy there are screening tests (prenatal tests) to check for spina bifida and other birth defects. Talk with your doctor about any questions or concerns you have about this prenatal testing.

• AFP – AFP stands for alpha-fetoprotein (sounds like: al-fa–fee-toe-pro-teen), a protein the unborn baby produces. This is a simple blood test that measures how much AFP has passed into the mother’s bloodstream from the baby. A high level of AFP might mean that the baby has spina bifida. An AFP test might be part of a test called the “triple screen” that looks for neural tube defects and other issues.
• Ultrasound – An ultrasound is a type of picture of the baby. In some cases, the doctor can see if the baby has spina bifida or find other reasons that there might be a high level of AFP. Frequently, spina bifida can be seen with this test.
• Amniocentesis (sounds like: am-knee-oh-sin-te-sus; hear how “amniocentesis” soundsexternal icon) – For this test, the doctor takes a small sample of the amniotic fluid surrounding the baby in the womb. Higher than average levels of AFP in the fluid might mean that the baby has spina bifida.

After the Baby Is Born

In some cases, spina bifida might not be diagnosed until after the baby is born.

Sometimes there is a hairy patch of skin or a dimple on the baby’s back that is first seen after the baby is born. A doctor can use an image scan, such as an, X-ray, MRI, or CT, to get a clearer view of the baby’s spine and the bones in the back.

Sometimes spina bifida is not diagnosed until after the baby is born because the mother did not receive prenatal care or an ultrasound did not show clear pictures of the affected part of the spine.

Treatments

Not all people born with spina bifida have the same needs, so treatment will be different for each person. Some people have problems that are more serious than others. People with myelomeningocele and meningocele will need more treatments than people with spina bifida occulta.

To learn more about treatments, visit the Treatments page.

Causes and Prevention

We do not know all of the causes of spina bifida. The role that genetics and the environment play in causing spina bifida needs to be studied further.

However, we do know that there are ways for women to reduce the risk of having a baby with spina bifida both before and during her pregnancy.

If you are pregnant or could get pregnant, use the following tips to help prevent your baby from having spina bifida:

• Take 400 micrograms (mcg) of folic acid every day. If you have already had a pregnancy affected by spina bifida, you may need to take a higher dose of folic acid before pregnancy and during early pregnancy. Talk to your doctor to discuss what’s best for you.
• Talk to your doctor or pharmacist about any prescription and over-the-counter drugs, vitamins, and dietary or herbal supplements you are taking. Learn about medication and pregnancy »
• If you have a medical condition―such as diabetes or obesity―be sure it is under control before you become pregnant.
• Avoid overheating your body, as might happen if you use a hot tub or sauna.
• Treat any fever you have right away with Tylenol® (or store brand acetaminophen).

Remember!

Spina bifida happens in the first few weeks of pregnancy, often before a woman knows she’s pregnant. Although folic acid is not a guarantee that a woman will have a healthy pregnancy, taking folic acid can help reduce a woman’s risk of having a pregnancy affected by spina bifida. Because half of all pregnancies in the United States are unplanned, it is important that all women who can become pregnant take 400 mcg of folic acid daily.

Living with Spina Bifida

Spina bifida can range from mild to severe. Some people may have little to no disability. Other people may be limited in the way they move or function. Some people may even be paralyzed or unable to walk or move parts of their body.

Even so, with the right care, most people affected by spina bifida lead full, productive lives.

Learn about living with spina bifida at different ages »

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Spina bifida (spina bifida) - treatment, symptoms, causes, diagnosis

Spina bifida (spina bifida) is a complex congenital defect in the development of the spinal cord and spine. This is a type of open neural tube defect in which there is an abnormal development of the back of the spine, the spinal cord, the surrounding nerves, and/or the fluid-filled sac that surrounds the spinal cord.

Spina bifida (back bifida) is an incurable, life-long condition that affects the neuromuscular and musculoskeletal systems.

This defect varies by type and ranges from moderate to severe.

Children with this defect may need corsets as the body grows, and in severe cases, a wheelchair.

Treatment is mainly aimed at slowing down the deformity and maintaining motor activity.

The defect may occur along the entire length of the spine and may present as part of the spinal cord and surrounding tissues protruding outward rather than inward. Approximately 85 percent of defects occur in the lower back and 15 percent in the neck and thoracic region. Surgically, it is possible to restore the integrity of the spinal column, but nerve damage cannot be restored, and if they are pronounced, then patients have various degrees of paresis of the lower extremities. The higher the defect on the spinal column, the more severe the nerve damage and movement disorders (paresis and paralysis).

According to studies, this developmental anomaly occurs in 7 cases per 10,000 newborns. There are several types of spina bifida that have varying degrees of severity.

• Latent spina bifida (spina bifida occulta) - the most moderate form, in which there are no obvious signs of malformation and changes in the skin. In this form, at least one vertebra changes, but the nerves and spinal cord do not bulge. A child at birth may have a spot or depression in the area of ​​the anomaly. And usually, the baby will not have symptoms. With this form of anomaly (as well as with others), there may be an anomaly in the development of the spinal cord, characterized by attachment of the spinal cord to the spine to the end of the lumbar region, when normally the spinal cord ends at the level of the first lumbar vertebrae and sags freely without attachment to the spine.
• Meningocele is a moderate (and the most common) anomaly in which the spinal canal is not properly closed and the meninges (membranes that cover the spinal cord) bulge outside the bony structures of the spinal canal, but the spinal cord itself remains intact. The cystic mass is covered with skin. Most children with meningocele have normal limb function, but may have partial paresis or abnormalities of the bladder or bowel. With this anomaly, there is often underdevelopment of the spinal cord. Almost all patients with this anomaly require surgery to close the defect and free the spinal cord.
• Lipomeningocele is an anomaly in which fatty tissue is attached to the spinal cord and puts pressure on it. Children with this form of anomaly may not have severe nerve damage, but bladder and bowel function may be impaired. In these cases, surgical treatment is also often used.
• Myelomeningocele: the most severe common form and associated with spina bifida. The spinal canal is not closed, and the bulging mass consists of the meninges, pathologically altered spinal cord, and nerves. In addition, in this area the skin is also underdeveloped. In children with this form of spinal cord splitting, paresis below the defect and dysfunction of the pelvic organs are observed in whole or in part. In addition, nerve damage and other pathologies are observed.

Symptoms

The symptoms of spina bifida vary greatly, depending on the form and severity of the individual child. For example, at birth:

• In latent splitting (spina bifida occulta), there may be no obvious signs or symptoms—only a small spot, depression, or birthmark.
• With a meningocele, there will be a sac-like protrusion that will be located on the back in the spinal region.
• With myelomeningocele, there will also be a protrusion, but with altered skin, there will be a release of nerves and spinal cord.

In severe spina bifida with localization in the lumbar spine, the following symptoms may occur: paralysis of the lower extremities, dysfunction of the bladder, intestines. In addition, these patients usually have other developmental anomalies:

• Hydrocephalus occurs in 75 percent of myelomeningocele cases and this condition requires operative endoscopic treatment in order to restore normal CSF flow or a shunt to drain excess fluid from the brain.
• Chiari anomaly (displacement of the brain into the upper cervical vertebrae) can cause pressure on the brainstem, which can manifest as impaired speech, swallowing, and motor disorders in the limbs.
• Underdevelopment of the spinal cord Orthopedic problems including scoliosis, kyphosis, hip dysplasia (congenital dislocation), combined deformities, clubfoot, etc.
• Precocious puberty (especially in girls with spina bifida and hydrocephalus).
• depression and other neurotic conditions
• obesity
• dermatological problems
• developmental anomalies of the urinary tract.
• heart disease
• vision problems

Diagnosis

Diagnosis may be performed during pregnancy to evaluate the fetus for spina bifida. These include:

• Amniocentesis: A procedure in which a long, thin needle is inserted through the mother's abdomen into the amniotic sac to remove a small amount of amniotic fluid for examination. The fluid is analyzed to determine the presence or absence of an open neural tube defect. Although the analysis is very reliable, it does not allow diagnosing small or closed defects.
• Prenatal ultrasound: this technique, being absolutely harmless, allows you to non-invasively assess the condition and visualize the internal organs, vessels, tissues of the fetus. Sometimes it is possible to diagnose not only spina bifida, but also other anomalies.
• Blood tests: It is recommended that blood tests be performed between 15 and 20 weeks of gestation for all women who have not previously had a child with an open neural tube defect and who have no family history of the condition. A blood test for alpha-fetoprotein and other biochemical parameters can determine how high the risk of developing spinal anomalies is.
• At birth, severe cases of spina bifida are evident by the presence of a fluid-filled sac bulging on the back of the newborn. Visual indicators of mild forms (spina occulta) may be a hairy patch on the skin or a depression along the spine. Unusual weakness or lack of coordination in the lower extremities also suggests spina bifida. In children and adults, this anomaly is often diagnosed during routine studies or, if necessary, to differentiate neurological symptoms using instrumental research methods (MRI, CT, radiography).

Causes

During pregnancy, the human brain and spinal column begin to form as a flat sheet of cells that folds into a tube called the neural tube. If all or part of the neural tube fails to close, then the open area is called an open neural tube defect. An open neural tube is open in 80 percent of cases, and is covered by bone or skin in 20 percent of cases. The cause of spina bifida (spina bifida and other defects) remains unknown, but is most likely the result of a combination of genetic, nutritional, and environmental factors, such as:

• maternal dietary deficiency of folic acid (vitamin B) during pregnancy (sufficient folic acid intake during pregnancy may reduce the risk of this anomaly).
• maternal uncontrolled diabetes
• Certain medicines (antibiotics, anticonvulsants).
• A genetic factor is usually only relevant in 10 percent of cases.
• Mother's age
• What kind of births on the account (firstborns are more at risk).
• Socioeconomic status (children born in lower socioeconomic families are at higher risk).
• ethnicity
• obesity or excessive consumption of alcohol by a pregnant woman
• When exposed to pregnant hyperthermia in the early stages (sauna, jacuzzi).

Treatment

Spina bifida can be treated immediately after birth. If this defect is diagnosed prenatally, then a caesarean section is recommended in order to reduce possible damage to the spinal cord during the passage of the birth canal. Newborns with meningocele or myelomeningocele are recommended to have surgery within 24 hours of birth. With such an operation, the bone defect is closed and it is possible to preserve the function of the intact part of the spinal cord. Unfortunately, surgical treatment cannot restore the function of damaged nerves as they are irreversible.

Currently, there are clinics that perform prenatal surgery to close the defect, but the techniques have not yet found wide application. The main task of treatment, both in a non-severe form and in the postoperative period, is to preserve the functions of both the musculoskeletal system and the functions of the bladder and intestines. If necessary, orthoses, therapeutic exercises, physiotherapy are used.

In cases where spina bifida is detected by chance during X-ray (MRI, CT) examination, measures must be taken to reduce the risk of spinal cord injury in the area of ​​the spine where this defect exists.

Operative treatment in adults is used only in the presence of complications. Basically, treatment in adults is aimed only at preventing possible complications (exercise therapy, physiotherapy, wearing a corset).

Spina bifida and how to treat it?

15. 07.2021

Spina bifida (spina bifida) is a developmental defect of the spine that occurs as early as the third week of fetal life and consists in incomplete closure of the spinal canal. The dorsal 9 can come out of this free space.0117 brain with meninges or meninges themselves (meningeal hernia ). What are the causes of spina bifida ? How is the treatment and rehabilitation of patients with spawning eggs divided in half?

Spina bifida - what is it?

Spina bifida, also known as meningeal hernia or bifid scar, is a birth defect that occurs in about 2.5% of live newborns. There is a violation of the formation of structures of the spinal brain and spine . It occurs in utero around the third week of pregnancy (although it is most often detected with high accuracy in the second trimester when seen on ultrasound ) and may appear along the entire length of the spine . The most common localization of hernia is the lumbar or lumbosacral segment (spina bifida L5 - S1). In about 75% of cases, this defect is accompanied by congenital hydrocephalus.

As a result, nerve conduction to various parts of the body is disturbed. We can also deal with the latent cleft, which the patient learns about in adulthood, because it is so limited and asymptomatic that it does not affect the functioning of the body.

The cause of this malformation of the spine is not fully understood. On the one hand, experts talk about genetic determinants and inheritance, on the other hand, about external phenomena, such as infections in the womb, deficiency of folic acid and B vitamins, exposure of pregnant women to X-rays, anticonvulsants.

Spina bifida - types of spina bifida

There are three main types of spina bifida: a bunch of hair, often the patient is not aware of the defect because there are no symptoms;

cystic fissure ( cystica ) - a bubble type cyst appears with a thin layer of skin, there are two types of this fissure. The first type - meningocele - cyst fluid contains tissue and spinal nerves , usually not severely damaged, there is no significant damage nerves , and operation includes repair of the dura and skin plastic surgery is rare. The second type - meningomyelocele - often formed cyst, in addition to tissues and cerebrospinal fluid, also contains nerves and part of the spinal cord that is damaged or abnormally developed; the degree of disability depends on the location and degree of damage, there is paralysis and loss of sensation below the level of the cyst, as well as problems with the bladder ; surgery is required to close the spinal canal and insert a valve into the ventricles of the brain if the circulation of cerebrospinal fluid is impaired and intracranial pressure is increased ;

cleft skull (cranium bifida) - occurs due to improper closure of the skull and bone defect, the developing cyst (encephalocele) consists of tissue, cerebrospinal fluid and even part of the brain ; babies with this defect are stillborn or die shortly after birth.

Spina bifida - symptoms

Spina bifida is often a tumor of various sizes on the back covered with thin skin. Sometimes only a depression or dimple, hair spot, bump, or red mole is found.

Depending on the type of cleft and the degree of its occurrence, one can speak of various clinical symptoms. The more the cleft appears in the lower back and the less widespread it is, the better the child will live a normal life. However, one should always remember that a child with spina bifida has several health problems related to different organs.

The most common symptoms of spina bifida include paresis of the limbs, forcing them to move in a wheelchair. Another problem is uneven circulation of cerebral fluid, which requires the position of the valve, as well as dysfunction of the urinary system. With a cleft located in the lumbosacral region, paresis or paralysis of the muscles of the lower extremities is flaccid, the position of the feet may be clubfoot, sphincter disorders lead to incontinence urine , and sensory disturbances are of the root type. In the case of a cleft, sensory disturbances located in the cervical or thoracic region are of the spinal type, and the lower limbs are of the pyramidal type. It happens that the symptoms of some meningeal hernias may not appear until ectopic development.

Spina bifida with age leads to such consequences of the disease as curvature of the spine , hip dislocation , muscle contractures and deformities bones and joints .

Spina bifida - treatment

Spina bifida is often diagnosed during pregnancy based on fetal ultrasound. The diagnosis is confirmed by the analysis of amniotic fluid.

After birth or while still in the womb (antenatal surgery ), your baby will have surgery to close hernia and reduce the risk of infection. Most often it is carried out in the first two days of life. Since this defect causes irreversible damage nervous system and various related problems, the child needs specialized care neurologist , orthopedist , urologist , physiotherapist and psychologist .

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