Spina bifida is a neural tube defect that results in the malformation of the vertebrae that cover the spinal cord. This condition can cause life-threatening complications, which can make surgery or medications necessary. Learning about spina bifida can help expectant parents or parents with a newly-diagnosed child understand this condition and how it is treated.
Types
Spina bifida can be classified as spina bifida occulta, meningocele or myelomeningocele. Spina bifida occulta is the most mild form of this condition. Some children with this form of Spina bifida do not have any health problems, while others have problems with walking, muscle function and bowel and bladder control. Meningocele is the type of spina bifida in which the covering of the spinal cord pushes through a defect in the bones of the spinal column. This forms a fluid-filled sac called a meningocele. Myelomeningocele is the most serious form of this condition This type of spina bifida occurs when the covering of the spinal cord and the spinal cord itself push through a defect in the spinal column. Because of this damage to the spinal cord, someone with myelomeningocele may be affected by paralysis.
Causes
Spina bifida's exact cause is not known. Researchers believe that environmental, genetic and nutritional factors play a role in the neural tube's failure to close completely. According to the National Institute ofNeurologic Disorders and Stroke, insufficient folic acid intake in a mother's diet plays a role in the development of spina bifida and related neural tube defects.
Risk Factors
While the cause of spina bifida has not been identified, there are some known risk factors for the condition. Spina bifida is more common among whites of northern European descent and Hispanics than African Americans and Asians. According to the Mayo Clinic, more female babies are born with this condition than male babies. If a family has a history of neural tube defects, the chance that a couple in that family will have a baby with a neural tube defect is increased. If a mother does not get adequate amounts of folic acid before and during her pregnancy, the risk of spina bifida is increased. Medications that are taken during pregnancy have been linked to neural tube defects. Valproic acid, which is used to treat seizures, is one drug that is associated with neural tube defects. If a mother is obese, has diabetes or has increased body temperature in the first few months of pregnancy, the risk of having a baby with spina bifida increases.
Signs & Symptoms
Spina bifida can cause a number of signs and symptoms, which range in severity based on the type of spina bifida and the location of the spinal lesion. Children with spina bifida occulta may have a birthmark, dimple or abnormal tuft of hair on the skin above the defect. More severe spina bifida occulta may be signaled by bowel and bladder incontinence, frequent urinary tract infections, muscle weakness, difficulty walking and loss of coordination. The most obvious sign of meningocele is the protrusion of the meninges through the opening in the spinal column at birth. Other signs of meningocele are bladder and bowel dysfunction and partial paralysis. Myelomeningocele can be recognized by the protrusion of the meninges and spinal cord through a spinal column defect. Children with this form of spina bifida may also have excessive fluid in the brain, mental retardation, urinary dysfunction, bowel dysfunction and partial or complete paralysis.
Diagnosis
Spina bifida can be diagnosed while a fetus is still in the womb. The maternal serum alpha-fetoprotein test is used to check the levels of a protein produced by the fetus. If levels of this protein are high, it can indicate that the developing fetus has a neural tube defect. Blood tests for inhibin A, human chorionic gonadotropin and estriol, which are hormones produced in the placenta, can also be done to determine if an abnormality is present. Spina bifida can also be diagnosed with ultrasound or amniocentesis.
Treatment
There is no cure for spina bifida, but some of its symptoms can be treated to improve quality of life and minimize neurological damage. Surgery can be done in cases of meningocele and myelomeningocele. Medications can be given to control symptoms such as overactive bladder and high blood pressure. Physical therapy can help children with spina bifida strengthen their muscles and improve coordination and balance.
