Spinabifida Effects

Spina bifida is a birth defect that affects the central nervous system due to an improperly formed vertebrae, which creates a cleft in the spine. Occurring early in pregnancy (within the first month), it is one of the most common congenital conditions.

Background

• Spina bifida is a neural tube defect, the neural tube being a fetal structure form that develops into the central nervous system. The defect occurs when the vertebrae that make up the spine do not fully form, creating a cleft in the spine that damages the central nervous system. It also creates a gap in the skin where the spine should be.
  In many cases of spina bifida the patient suffers from hydrocephalus, in which the cerebrospinal fluid collects in the brain's ventricles and causes them to swell. Patients with spina bifida can develop an enlarged head in their infancy.
  The causes of spina bifida are unknown, but it is believed that it involves a combination of factors such as heredity, environment, a deficiency of folic acid, certain anti-seizure medications and even the presence of diabetes and obesity.
  There are three main types of spina bifida: spina bifida occulta, spina bifida cystica meningocele and spina bifida cystica myelomeningocele. The latter two involve the formation of cysts (sacs of tissue and fluid).

Spina Bifida Occulta

• Spina bifida occulta is the most mild of the three, involving a slight deformity in often only one vertebra. Many who have this form of spina bifida will never know about it unless it is revealed by an unrelated investigation. The only hint that is present may be the form of a mole, dimple or patch of hair on the back.
  Despite the mildness of the condition, there is potential for complication, especially if the cleft is bigger and involves more than one vertebrae. The spinal cord can get caught on the vertebrae, which can cause damage to the nervous system and affect the lower half of the body in a number of ways including deformed feet, loss of feeling in the legs and difficulties in controlling one's bladder and bowels.
  Women are at risk to pass it on to their children, so proper prevention methods are recommended. Even those with spina bifida occulta (especially the more problematic type) can have children that bear the cystic types of spina bifida.

Spina Bifida Cystica Myelomeningocele

• Spina bifida cystica myelomeningocele, also called open spina bifida, is the most common form of cystic spina bifida and the most dangerous. Protective tissue (menignes), cerebrospinal fluid, nerves and part of the spinal cord come out of the cleft in the spine and form a cyst on the back. Sometimes skin covers the cyst, but often it does not. Such exposure can result in severe infections such as meningitis.
  Paralysis is common, but the amount of nerve damage determines the degree of disability. The nerve damage can make one prone to seizures and affects one's ability to control the bowels and bladder. It can also result in learning disabilities, skin problems and a variety of emotional disorders.

Spina Bifida Cystica Meningocele

• Spina bifida cystica meningocele also involves a similar cyst on the back but is less common and far less dangerous than the myelomeningocele type. The cyst contains meninges and cerebrospinal fluid, but no parts of the spine. Often little damage occurs, this resulting in only minor disability.

Treatment and Prevention

• The most mild forms of spina bifida occulta require no treatment. More serious forms can be treated with an operation to untether the spine from the vertebrae. The operation is meant to prevent further damages from the tethering, but it can improve leg problems. Unfortunately, bladder problems tend to remain.
  Spina bifida cystica meningocele requires surgery to replace the contents of the cyst and close up the opening in the infant's vertabrae.
  Surgery to treat spina bifida cystica myelomeningocele is more pressing and must be performed immediately to reduce damage to the spinal cord and prevent infection. It is similar to the treatment of the meningocele type but involves replacing sensitive elements like the spinal cord and the nerves and covering them with muscle tissue. After the initial surgery, babies must undergo continued care and sometimes even additional surgeries to reduce disability.
  Pregnant women who have detected spina bifida in their fetus can undergo Caesarian birth to safely deliver the baby and immediately place it in the care of a neurosurgeon to operate. There is also the possibility of prenatal surgery, performed around halfway through pregnancy, which can reduce disability in the brain but has a risk of fetal death and does not help bladder function.
  Women who are trying to conceive can obtain a prescription of folic acid supplement in order to help prevent them from passing spina bifida on to their children. This can prove most effective if it supplements healthy eating practices and a diet rich in folic acid.