Spina bifida is a birth defect (congenital disability). This condition occurs due to an undeveloped spine and spinal cord. This is a form of neural tube defect. The neural tube is a structure found within a developing embryo and is responsible for forming the baby’s brain, spinal cord, and other tissues surrounding these organs.
The neural tube is generally formed in the early days of pregnancy and is closed after 28 days following conception. In babies with the condition of spina bifida, the neural tube fails to close completely or forms improperly, resulting in problems associated with the spinal cord and the bones in the spine.
The severity of spina bifida varies based on factors like defect type & its size, location of the defect & its complications. In some cases, surgery may be the early treatment for spina bifida.
Types of spina bifida
Spina bifida is categorized into three different types:
- Spina bifida occulta
- Myelomeningocele
- Meningocele (very rare type)
Spina bifida occulta (SBO)
“Occulta” is a Latin word that refers to something hidden. This is the most common type and mildest variant. Here, the spine and the nerves function normally, but there could be a small space between the vertebral bone. The condition usually goes unnoticed until it causes serious problems later in life or is diagnosed when they get tested for some other reason.Many times it remains a anatomic peculiarity and patient does not have any symptoms. These can be associated with a dysplastic variant of spondylolisthesis. Some patients have a tuft of hair on the lower back.
Myelomeningocele
It is also called open spina bifida and is a severe type. In this condition, a sac of spinal fluid is pushed out of the baby’s back at several places along the vertebrae through an opening in the lower or middle back. There are nerves and parts of the spinal cord in this sack, and they get damaged too.
People with this condition have physical disabilities ranging from mild to severe, and they are:
- incontinence
- Having a hard time going to the bathroom
- The inability to move their legs or feel their feet
The baby is then at risk of paralysis and infections that may be fatal.
- Meningocele
This is a rare type and occurs when a sac of spinal fluid (the sac doesn’t have parts of the spinal cord and nerves) pokes out through an opening in the baby’s back. Symptoms can vary greatly; some may have no or few symptoms, while some babies experience bladder and bowels problems.
Symptoms of spina bifida
The signs and symptoms vary depending on the type of spina bifida and its severity.
Meningocele exhibits symptoms related to bladder and bowel functions. You can also see the sac protruding out of the infant’s back.
Since the spinal nerves aren’t affected, there are no signs or symptoms of this condition. In some cases, you may observe a tuft of hair or a birthmark as the signs of this condition. Sometimes, these marks on the skin may also indicate the signs of some other underlying spinal cord problems in a newborn.
An opening in a spinal canal along the vertebrae, often in the middle or lower back, is the primary symptom of myelomeningocele spina bifida. Other symptoms include:
- The spinal cord and nerves are pushed outside and exposed like a skin-covered sack in the back
- weak leg muscles
- seizures
- Foot deformities
- Uneven hips
- Scoliosis
- Bladder and bowel problems
Since the spinal nerves aren’t affected, there may be no signs or symptoms for spina bifida occulta. In some cases, you may observe a tuft of hair or a birthmark as the signs of this condition. Sometimes, these marks on the skin may also indicate the signs of some other underlying spinal cord problems in a newborn.
Causes of spina bifida
There are no known causes of spina bifida. The condition is thought to be caused by a combination of genetic and environmental factors. A child born with spina bifida may not have any family members with spina bifida, although genetics might play a role. It is believed that folic acid deficiencies (vitamin B9) may also cause spina bifida.
The condition is commonly observed in white and Hispanic babies, especially in girls. Furthermore, women with poorly controlled diabetes or obese women are at higher risk of having a child with spina bifida.
Treatment for spina bifida
Spina bifida treatment varies from person to person based on the signs and symptoms and their severity. Treatment may not be required in some cases, especially in spina bifida occulta.
However, myelomeningocele and meningocele spina bifida need surgical intervention in order to reposition the exposed nerves and sack. Some portions may need to be removed in some cases during surgery. The opening over the vertebrae is then closed by the surgeon. To avoid complications later in life, a shunt may be implanted. A procedure like this may be done soon after the baby is born. Occasionally, a prenatal operation may be performed, i.e., a surgical procedure is done when the child is in the mother’s womb.
It is possible for some symptoms and disabilities to persist even after surgery. Each symptom will require a different approach based on its severity. Generally, problems with the bowels, bladder, and paralysis persist throughout life. Treatment for other symptoms include:
- The need for additional surgery
- Medicines
- Physical therapy
- Rehabilitation
Some patients need assistive walking devices, back braces, or wheelchairs to help them move around.
To know more details about treatment, consult Dr. Surya Prakash, one of the best spine doctors in Hyderabad. He has more than two decades of experience in treating multiple spinal problems, which include spina bifida successfully.
