What is spina bifida

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A fault in the development of the spinal cord and surrounding bones (vertebrae) leaves a gap or split in the spine. The spinal cord has not formed properly, and may also be damaged. To help understand what it is, it is useful to explain the composition of the nervous system.

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What is spina bifida

  1. 1. shinecharity.org.uk info@shinecharity.org.uk 42 Park Road Peterborough PE1 2UQ 01733 555988What is Spina Bifida?Spina bifida literally means for the body is very important and‘split spine’ needs protection.A fault in the development of the The Spinespinal cord and surrounding bones(vertebrae) leaves a gap or split The spine is made up of 33 bonesin the spine. The spinal cord has or vertebrae. The vertebrae havenot formed properly, and may also two main functions. One is tobe damaged. To help understand provide anchorage for muscleswhat it is, it is useful to explain the so that we can move as the braincomposition of the nervous system. dictates to those muscles. The other is to provide protection toThe Central Nervous System the spinal cord.The central nervous system consists The Neural Tubeof the brain and the spinal cord.All activities are controlled by the The central nervous system andbrain which receives information spine develops between the 14thfrom touching, seeing, feeling, and 23rd day after conception.tasting and hearing – responding Spina bifida occurs when theto this information by initiating the neural tube fails to close correctly.appropriate movements of different The vertebrae also fail to closeparts of the body. Messages from in complete rings around thethe brain are carried to different parts affected portion of the spinal cord.of the body by the spinal cord which This leaves a gap posteriorly (atruns down the centre of the spinal the back), involving one or morecolumn. This communication system vertebrae. The fault may occur in
  2. 2. What is Spina Bifida?one or more of the vertebrae but it is most common around waist-level. Types of Spina BifidaNerves which control the movement The three main types of spina bifidaof different parts of the body always present at birth are: 8 Cervical nerve Spina Bifida Cystica pairs Use of (cyst-like) neck, shoulders and arms The visible signs are a sac or cyst, rather like a large blister on the 12 Thoracic back, covered by a thin layer of nerve pairs skin. Use of hands There are two forms: and fingers, chest and 1) Myelomeningocele abdomen, lower (meningomyelocele) back and hip Myelomeningocele is the most 5 Lumbar nerve serious and more common of the pairs. Use of two forms of cystic spina bifida. ‘seat’ muscles Here the cyst not only contains to keep body tissue and cerebro-spinal fluid but erect, leg, knee also nerves and part of the spinal and foot and in cord. The spinal cord is damaged men, ejaculation or not properly developed. As a result, there is always some 5 Sacral nerve paralysis and loss of sensation pairs below the damaged region. Bowel and The amount of disability depends bladder and in very much on where the spina bifida men control of is, and the amount of affected nerve erections tissue involved. Bladder and bowel
  3. 3. problems occur in most people with cerebro-spinal fluid, which bathesmyelomeningocele, as the nerves the central nervous system.come from the bottom of the spinal Development of the spinal cordcord, so are always below the may be affected, but impairmentlesion. It is also necessary to have is usually less severe thanintact nerve pathways to the brain myelomeningocele. Meningocelefor complete control and sensation. is the least common form of spina bifida. Spinal cord CSF Skin Meninges Cerebrospinal Skin Fluid (CSF) The outer part of the vertebrae is split. The outer part of the vertebrae isThe spinal cord and meninges are split. The spinal cord is normal.damaged and pushed out through The meninges are damaged andthe opening. Hydrocephalus is pushed out through the opening.usually associated with this form. Spina Bifida Occulta 2) Meningocele (hidden form)In this form, the sac contains This is a mild form of spina bifidameninges (tissues which cover which is very common. Estimatesthe brain and spinal cord) and vary but between 5% and 10%
  4. 4. What is Spina Bifida?of people may have spina bifida occulta. It must be emphasised Encephalocelethat, for the vast majority of thoseaffected, having spina bifida occulta This is a sac which is formed whenis of no consequence whatsoever. the bones of the skull fail to develop.Often people only become aware It may contain only cerebro-spinalthat they have spina bifida occulta fluid or part of the brain may alsoafter having a back x-ray for an be present in the sac, resulting inunrelated problem. brain damage.However, for a few (about 1 in Anencephaly1,000) there can be associatedproblems. See Shine’s information This is where the brain does notsheet on ‘Spina Bifida Occulta’. develop properly or is absent, and the baby is either still born or dies shortly after birth. Contact Shine for further information. Hydrocephalus Most babies born with Hair (or dimple) myelomeningocele also have often at site of hydrocephalus (from the Greek defect hydro, meaning water, and cephalie meaning brain). This is an Skin accumulation of cerebro-spinal fluid which arises from an imbalance in the production and drainage of that fluid. Further information about hydrocephalus is given in Shine Information Sheet ‘What isThe outer part of the vertebrae is not Hydrocephalus?.completely joined. The spinal cordand its covering (the meninges) areundamaged Encephalocele
  5. 5. whether the child should haveWhy does Spina Bifida surgery to repair the defect in thehappen? back: this surgery will take place in a specialist unit usually withinAt present causation is unknown 48 hours. Some surgeons do notand research continues. However, close the back surgically but leavewe do know that taking folic acid it to heal without intervention.supplements can reduce the riskof spina bifida in unborn babies. Genetic CounsellingFor families with no history ofspina bifida the Dept. of Health Prospective parents who have hadrecommends women take an ‘over a baby with a neural tube defect,the counter’ dose of 400mcg daily. or who have a close relative withFor families where there is a history a neural tube defect, should beof spina bifida, a prescription dose refered to a genetic counsellor for(5mg) of folic acid is needed. Folic advice.acid should be taken daily for atleast one month prior to conception Supportand through to the 12th week ofpregnancy. Even with fortification Shine plays a leading role inof flour products with folic acid, a providing support, through nationalsupplementary tablet is needed. and regional offices and localThe exact reasons why the neural associations, it offers informationtube develops incorrectly are and practical advice. Families whonot yet known but it is probably have a child or adult with a disabilityconnected with both genetic and can sometimes feel very isolatedenvironmental factors. and Shine can provide often much needed contact with other families.How is Spina Bifida treated ? Information and publications are available on all aspects of care andThe baby will be seen by a management. Our national andpaediatric surgeon or paediatric regional staff, area and specialistneurosurgeon shortly after birth. advisers will give personal adviceThe surgeon will then decide and support whenever possible.
  6. 6. Our services are available toindividuals with the disabilities,parents, health professionals,schools, local authorities and otherinterested organisations.Help usShine relies on people’s generosity and support so we can help our clientswho depend on us for help and advice - people with hydrocephalus,spina bifida, their families and carers. To donate to Shine please visitwww.shinecharity.org.uk or call 01733 421329.This information has been produced by Shine’s medical advisers andapproved by Shine’s Medical Advisory Committee of senior medicalprofessionals.Shine - Registered charity no.249338To see our full range of information sheets and to find out how to donateto Shine please visit www.shinecharity.org.uk

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