Spina bifida is known as a birth defect that occurs when the spinal cord does not form properly. It falls into the wider category of neural tube defects. The neural tube is the embryonic structure that develops towards the baby’s spinal cord and brain and the tissues that surround them. Normally, the neural tube occurs early in pregnancy and closes completely on the 28th day after conception. In babies with spina bifida, a section of the neural tube does not develop properly or does not close completely. This leads to damage to the spine and spine bones. Spina bifida may be severe or mild, depending on the type, location, size, and complications of this problem. When early treatment for spina bifida is required, surgery is performed even if it does not completely resolve each condition.
What is Spina Bifida Types?
Spina bifida is divided into different species. These;
- Occulta: Occulta means hidden in words. Occultada, the lightest form of Spina bifida species, does not have a neurological symptom or symptom in many patients. There may be a small birthmark or a small amount of hair on the skin with the spinal defect. Patients cannot know that they have spina bifida unless a test for another problem shows it by chance.
- Meningocele: In the form of another spina bifida called meningocele, the protective membranes (known as meninges) around the spinal cord flow out of the opening in the spine to form a pouch filled with liquid. However, this pouch does not cover the spinal cord and therefore nerve damage is much lower. However, complications may occur at a later stage.
- Myelomeningocele: Myelomeningocele, also called open spina bifida, is the most severe form of this problem. The spinal canal is open across several vertebrae in the middle or lower back. The spinal cord nerves and membranes pass through this opening during birth and form a sac in the baby’s back. In general, this situation reveals nerves and tissues. This action makes it much more prone to infections that could threaten the baby’s body.
- Closed Neural Tube Defects: In this form, there may be different potential problems in the bone, fat, or meninges of the spinal cord. In many cases, there is no indication. However, some patients may have partial paralysis, bowel disorders, and urinary incontinence.
What are the Symptoms of Spina Bifida?
Signs and symptoms of spina bifida vary according to the severity and type of this problem. Also, symptoms may be different for each patient. Symptoms of spina bifida in general are;
- Occulta: Since the spinal nerves are not generally included in this problem, there are no symptoms or signs. However, in some cases, visible symptoms may occur abnormally on the spinal defect in the baby’s skin, including hair, birthmark, and a small cup.
- Meningocele: The membranes around the spinal cord leak out through an opening in the vertebrae. This creates a pouch filled with liquid. However, this pouch does not include the spinal cord.
- Myelomeningocele: In this most severe form of spina bifida, the spinal cord will remain open along several vertebrae in the middle or lower back. Both the spinal cord and the membranes or nerves will protrude during labor to form a sac. Nerves and tissues generally occur, and in some cases, this skin covers the pouch.
What are the Causes of Spina Bifida?
Experts are not certain which condition causes spina bifida. It is generally thought to be caused by a combination of environmental and genetic risk factors such as folate deficiency or family history, as is the case with many other problems.
Spina Bifida Risk Factors
Women with spina bifida are much more at risk than men. Although experts have not fully understood why spina bifida occurs, some risk factors trigger this problem. These;
- Folate deficiency: Folate (vitamin B-9) is very important for the healthy development of infants. Folate is known as the natural form of vitamin B-9. The synthetic form found in supplements is called folic acid. Folate deficiency can increase the risk of spina bifida problems and other possible neural tube defects.
- Family history: Couples who have a child with a neural tube defect will be more likely to have another baby suffering from the same problem. This risk situation increases if two previous children are affected by the problem. However, a woman born with a neural tube defect will be much more likely to give birth to a child with spina bifida.
- Diabetes: Women with diabetes who cannot healthily control blood sugar are likely to have a baby with spina bifida.
- Obesity: Obesity before pregnancy is associated with an increased likelihood of neural tube birth defects, including the problem of spina bifida.
- High Body Temperature: According to some evidence, increased body temperature (known as hyperthermia) during the first weeks of pregnancy may increase the risk of spina bifida.
What Problems does Spina Bifida Cause?
Spina bifida may cause minimal symptoms or only minor physical injuries. If spina bifida is severe, it may in some cases lead to more important physical problems. Spina bifida can cause the following problems, but not always;
- Gait and Movement Problems: The nerves that govern the leg muscles do not work properly in the area with spina bifida. This causes weakening of the muscles in the legs and some cases cause paralysis.
- Orthopedic Problems: Children with myelomeningocele type may experience different problems in the spine and legs due to the weak muscles in the back and legs. The problems will generally depend on the level of the disease. Possible problems include an abnormal dislocation of the hip, curved spine (scoliosis), joint and bone deformities, muscle contractures, and other possible orthopedic concerns.
- Bladder and Bowel Problems: The nerves that feed the bowel and bladder generally do not work properly when children have myelocellosocele type. This is because the nerves that feed the bladder and intestine come from the bottom of the spinal cord.
- Accumulation of Fluid in the Brain (Hydrocephalus): Babies born with myelomeningocele type generally experience fluid accumulation in the brain, also known as hydrocephalus.
- Chiari Malformation Type 2: This problem is known as a common brain abnormality in infants born with myelomeningocele form. In this problem, the brain stem is positioned much lower than normal. This may cause problems with swallowing and breathing. Rarely, pressure can form in this area of the brain and surgery can be performed to reduce the pressure.
- Infections in Tissues Surrounding the Brain (Meningitis): Some infants with myelomeningocele form may develop meningitis, an important infection in the tissues surrounding the brain. This life-threatening infection can cause brain damage.
- Connected Spinal Cord: The connected spinal cord occurs when the spinal nerves are closed by surgical operations and connected to the scars, and the spinal cord grows much less as the baby grows. This progressive attachment can cause muscle function loss in the intestines, legs, or bladder. Surgical operations may limit the level of disability.
- Sleep Disorders: Spina bifida, especially myelomeningocele form, can cause sleep disorders and sleep apnea in both infants and adults. In patients with myelomeningocele form, assessment of sleep disorders helps to identify sleep disorders to improve quality of life and overall body health.
- Skin Problems: Children with spina bifida may have sores on their legs, feet, buttocks, and back. These wounds can cause significant infections.
- Latex Allergy: Children with this problem may have a risk of latex allergy or an allergic reaction to latex product types. Latex allergy can cause sneezing, skin rashes, itching, watery eyes, and runny nose. This can also lead to anaphylaxis.
In children with spina bifida, problems such as gastrointestinal diseases, urinary tract infections, and stress may develop with age.
Spina Bifida Treatment
Spina bifida treatment generally depends on how severe the signs and symptoms are. In general, spina bifida treatment consists of;
- Spine repair surgery: This operation can be performed immediately after birth. Corrective operations may be necessary if bone development problems such as dislocated joints or scoliosis occur later.
- Prenatal Surgery: This operation is generally performed between 19 and 25 weeks of pregnancy. The doctor fixes the problem by repairing the spinal cord of the fetus.
- Hydrocephalus: Surgical operation treats the accumulation of spinal fluid in the brain.
This treatment helps the patient to become independent and prevents the weakening of the lower muscles. Specially developed leg supports will help keep muscles as strong as possible.