2. What is Spina Bifida Myelodysplasia (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 Bifida Spina 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 defect Meningoceles, 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 Look Spina 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. Symptoms A 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 control Partial or complete lack of sensation Partial or complete paralysis of the legs Weakness of the hips, legs, or feet of a newborn Other symptoms may include: Abnormal feet or legs, such as clubfoot Build up of fluid inside the skull (hydrocephalus) Hair at the back part of the pelvis called the sacral area Dimpling of the sacral area Possible medications
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 swell As the brain swells it presses against the skull, and causes pressure on the brain tissue If untreated, this can cause seizures, vomiting, irritability, sleepiness and brain damage
9. Treatment The goal of treatment is to reduce or prevent brain damage by improving the flow of CFS A shunt system is placed in the brain in order to drain excess CFS The shunt tubing travels to another part of the body, such as the abdomen, where the extra CSF can be absorbed
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. Prognosis Myelomeningocele 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 scoliosis foot or ankle deformities dislocated hips joint tightness or contractures Infections within the shunt system
13. Prevention Folic 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. Complications Difficult delivery with problems resulting from a traumatic birth, including cerebral palsy and decreased oxygen to the brain Frequent urinary tract infections Hydrocephalus Loss of bowel or bladder control Meningitis Permanent weakness or paralysis of legs
15. Treatment Genetic 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 Continued Most children will require lifelong treatment for problems that result from damage to the spinal cord and spinal nerves. This includes: Catheters Braces High fiber diet Antibiotics may be used to treat or prevent infections such as meningitis or urinary tract infections.
17. Implications for Recreation Many individuals with Spina Bifida are allergic to latex. Be aware of… Swimming caps Balloons Rubber balls Food allergies: bananas, kiwis, avocados and chestnuts
