Spina bifida is a birth defect where the backbone and spinal canal do not close before birth, causing part of the spinal cord to protrude out of the back. It affects around 1 in 800 infants and can range from a mild condition where the spine does not fully close to more severe cases where parts of the spinal cord and membranes protrude out. Symptoms include issues with bladder/bowel control, paralysis, and hydrocephalus in many cases. Prenatal screening and folic acid supplementation can help reduce risks, while surgery after birth and lifelong treatment can address symptoms and complications.

1. Jessica EstepLisa BurdueCarlyAmatistoSpina Bifida

2. What is Spina BifidaMyelodysplasia (spina bifida) is a birth defect in which the backbone and spinal canal do not close before birth. Myelomeningocele may affect as many as 1 out of every 800 infants.

3. Types of Spina BifidaSpina Bifida cases include :Spina bifida occulta, a condition in which the bones of the spine do not close but the spinal cord and meninges remain in place and skin usually covers the defectMeningoceles, a condition where the tissue covering the spinal cord sticks out of the spinal defect but the spinal cord remains in place.

4. A Closer LookSpina bifida refers to any birth defect involving incomplete closure of the spine.Myelomeningocele is the most common type of spina bifida. It is a neural tube defect in which the bones of the spine do not completely form, resulting in an incomplete spinal canal.This causes the spinal cord and meninges (the tissues covering the spinal cord) to stick out of the child's back.

5. SymptomsA newborn may have a sac sticking out of the mid to lower back. The doctor cannot see through the sac when shining a light behind it. Symptoms include:Loss of bladder or bowel controlPartial or complete lack of sensationPartial or complete paralysis of the legsWeakness of the hips, legs, or feet of a newbornOther symptoms may include:Abnormal feet or legs, such as clubfootBuild up of fluid inside the skull (hydrocephalus)Hair at the back part of the pelvis called the sacral areaDimpling of the sacral areaPossible medications

6. Explains HydrocephalusDr. Puppet

7. Hydrocephalus“water on the brain”80% - 90% of children with spina bifida will also develop hydrocephalus

8. What is Hydrocephalus?Excess cerebral spinal fluid (CSF) in the brain which causes the brain tissue to swellAs the brain swells it presses against the skull, and causes pressure on the brain tissueIf untreated, this can cause seizures, vomiting, irritability, sleepiness and brain damage

9. TreatmentThe goal of treatment is to reduce or prevent brain damage by improving the flow of CFSA shunt system is placed in the brain in order to drain excess CFSThe shunt tubing travels to another part of the body, such as the abdomen, where the extra CSF can be absorbed

10. And Now… I Shall DemonstrateAny volunteers?

11. Test & Diagnosis Prenatal screening can help diagnose this condition. During the second trimester, pregnant women can have a blood test called the quadruple screen.Most women carrying a baby with spina bifida will have higher-than-normal levels of a protein called maternal alpha fetoprotein (AFP).

12. PrognosisMyelomeningocele can usually be surgically corrected. With treatment, length of life is not severely affected. Neurological damage is often irreversible.Many individuals with spina bifida primarily use a wheelchair. Life long issues include:more loss of function as well as orthopedic problems such as scoliosisfoot or ankle deformitiesdislocated hips joint tightness or contracturesInfections within the shunt system

13. PreventionFolic acid supplements may help reduce the risk of neural tube defects such as myelomeningocele. It is recommended that any woman considering becoming pregnant take 0.4 mg of folic acid a day. Pregnant women need 1 mg per day.It is important to remember that folic acid deficiencies must be corrected before becoming pregnant as the defects develop very early.Prospective mothers may be screened to determine the amount of folic acid in their blood.

14. ComplicationsDifficult delivery with problems resulting from a traumatic birth, including cerebral palsy and decreased oxygen to the brainFrequent urinary tract infectionsHydrocephalusLoss of bowel or bladder controlMeningitisPermanent weakness or paralysis of legs

15. TreatmentGenetic counseling may be recommended. Surgery to repair the defect is usually recommended at an early age. Children who also have hydrocephalus may need a ventricular peritoneal shunt placed. This will help drain the extra fluid.

16. Treatments ContinuedMost children will require lifelong treatment for problems that result from damage to the spinal cord and spinal nerves. This includes:CathetersBracesHigh fiber dietAntibiotics may be used to treat or prevent infections such as meningitis or urinary tract infections.

17. Implications for RecreationMany individuals with Spina Bifida are allergic to latex. Be aware of…Swimming capsBalloonsRubber ballsFood allergies: bananas, kiwis, avocados and chestnuts

18. Recreation IdeasPuppetsAdaptive bowlingSwimmingCanoeingHorseback ridingWheelchair basketball

19. Support Groupshttp://www.waisman.wisc.edu/~Rowley/sb-kids/index.html A resource for families and providers Spina Bifida Association- Regional and Nationalhttp://spina-bifida-bibliography.blogspot.com http://www.shrinershq.org/Hospitals/Main/: Shriners Children Hospital

20. Referenceshttps://health.google.com/health/ref/Myelomeningocelehttp://www.medicinenet.com/spina_bifida_and_anencephaly/index.htmhttp://www.waisman.wisc.edu/~Rowley/sb-kids/index.html