Spina bifida awareness : everything you need to know about the disorder

Spina bifida is a birth disorder in which the spine doesn't fully develop. In the first month of pregnancy, a group of cells normally forms the “neural tube,” that eventually develops into the brain and spinal cord.Neural tube problems happen early in pregnancy when the neural tube does not form normally.

Each person with spina bifida has different abilities and health challenges. A baby born with spina bifida may have nerve damage, and some will have learning disabilities. There is no cure for spina bifida but most people lead a healthy life even with Spina Bifida.

What is Spina Bifida?

Spina bifida is a neural tube defect (NTD) that occurs when the neural tube doesn't close properly during pregnancy, which leaves a slit or opening in the spine. It is also part of a group of birth defects, affecting the brain and/or spine. A birth defect in which a developing baby's spinal cord fails to develop properly while in the womb. 

The consequence of spina bifida in this respect can vary greatly, in some cases not causing many problems, and in others, it can result in severe physical and even neurological handicaps. 

Spina Bifida Types

Three main types of spina bifida exist: 

• Spina Bifida Occulta: The most common and mild type, in which one or more of the individual vertebrae are found to be malformed. It is usually without any overt symptom and is typically discovered incidentally. 
• Meningocele: It is a rare form, in which a sac of fluid protrudes through an opening in the spine, and the containing sac contains no part of the spinal cord or any nerve. It may cause some symptoms, but usually, they are much less severe. 
• Myelomeningocele: This is the most serious degree of spina bifida, in which part of the spinal cord and nerves protrude through an opening in the spine. It results in high degrees of neurological impairments. Many cases of this type may need immediate medical attention to avoid further complications arising from the condition. 

Spina Bifida Causes

The real cause of spina bifida has not yet been determined, but several risk factors can enhance the chances of development of the condition: 

• Genetic: A neural tube defect present in a family can predispose the next member to spina bifida. 
• Nutritional Cause: Inadequate intake of folic acid during pregnancy is among the major known risk factors. Folic acid contributes to the good development of the unborn's neural tube. 
• Environmental Causes: Exposure to chemicals, certain medications, and high temperatures during pregnancy. 
• Medical Conditions: Conditions such as diabetes and obesity in the mother may raise the levels of risk of the child getting spina bifida. 

Spina Bifida Symptoms

The potential symptoms associated with spina bifida vary and depend on the type and severity of the respective condition: 

Spina Bifida Occulta: The condition is asymptomatic generally, with nothing remarkable in terms of visible signs and symptoms. 

Meningocele: Signs could be visible on the back consisting of a sac. Features include mild weakness or problems with bladder and bowel control. 

Myelomeningocele: Muscle weakness or paralysis, absence of sensation below the defect, bladder and bowel dysfunction, poor orthopedic conditions such as scoliosis or clubfoot, and cognitive deficits are characteristic features in this case. 

Spina Bifida Diagnosis

Mostly, spina bifida is diagnosed in the following manner: 

• Prenatal Screening: A few blood tests, for example, maternal serum alpha-fetoprotein (MSAFP) test that detects neural tube defects during pregnancy. Ultrasound scanning will help to find the presence of spina bifida. 
• Amniocentesis: A small quantity of the amniotic fluid is withdrawn from the womb. This test can be conducted to diagnose genetic disorders. 
• Postnatal diagnosis: After birth, the physical examination and other diagnostic tests like X-rays, MRI, or CT scans can be carried out to determine the diagnosis and its severity grading. 

Also Read : Best Prenatal Vitamins For Pregnancy 

Surgical management of Spina bifida

The following are the options available for treating spina bifida, depending on the type and severity of the disease.

Non-surgical Management: 

• Physical Therapy: Enhances mobility and strength, especially in people with mild to moderate symptoms. 
• Occupational Therapy: Enhances daily living skills and independence. 
• Assistive Devices: In more severe cases, braces, crutches, or wheelchairs to restore mobility.
•  Bladder and Bowel Management: Medications, catheterization, or surgery may be used to handle incontinence. 

Surgical Management of Spina Bifida: 

• Prenatal Surgery: Occasionally, the repair surgery of the defect of the spinal part is done while the baby is yet to be born. In turn, it may help in reducing risks and complications like hydrocephalus conditions related to the accumulation of fluids in the brain. 
• Postnatal Surgery: This surgery after birth is intended to close the gap in the spinal cord to protect against infections and prevent damage to the spinal cord from escalating. In cases of myelomeningocele, this surgery often takes place within the first 72 hours of birth.

Spina bifida : When to See a Doctor?

Consult a doctor if the above mentioned symptoms are present since they indicate spina bifida: Noticeable abnormalities in the back, including a small tuft of hair, dimple, or sac-like protrusion. Developmental delays, such as difficulties walking, or controlling bladder or bowel function. Signs and symptoms of neurological damage, such as numbness, weakness, or loss of sensation. 

Spina bifida : Conclusion

The earlier the diagnosis and intervention, the greater the role in improving life and less the chances of complications. Those affected by spina bifida can lead a fruitful life with the right kind of medical, therapeutic, as well as lifestyle adjustments. 

References:

1. What is Spina Bifida?. Spina Bifida Association[Internet]. https://www.spinabifidaassociation.org/resource/spina-bifida/. Accessed Aug. 26, 2024.
2. About Spina Bifida. US Centers for Disease Control and Prevention[Internet]. https://www.cdc.gov/spina-bifida/about/index.html. Accessed Aug. 25, 2024.
3. Spina Bifida. National Institute of Neurological Disorders and Stroke[Internet].  https://www.ninds.nih.gov/health-information/disorders/spina-bifida. Accessed Aug. 30, 2024.
4. Spina Bifida. American Association of Neurological Surgeons [Internet].  https://www.aans.org/patients/conditions-treatments/spina-bifida/. Accessed Aug. 25, 2024.