The name "spina bifida" derives from the Latin word "split spine," referring to a birth abnormality in which the tissue on the left and right sides of the back that typically protects the spinal cord does not. Spina bifida is a deformity of the spine that is usually visible from birth. It's a particular kind of neural tube defect (NTD).
Birth disorders of the neural tube The neural tube normally forms early in pregnancy and shuts by the 28th day following conception, preventing brain, spine, or spinal cord abnormalities. They usually occurs in the first month of pregnancy, before a woman even realises she is expecting. Spina bifida and anencephaly are the two most prevalent neural tube anomalies. The fetal spinal column does not close completely in spina bifida.
If the neural tube does not shut completely, spina bifida can occur anywhere along the spine. The severity of spina bifida varies based on the type of lesion, its size, location, and consequences.
Causes
Spina bifida is a condition that no one knows what causes. It could be a combination of environmental factors and family history, or a shortage of folic acid (a form of vitamin B) in the mother's body, according to scientists.
However, Caucasian and Hispanic babies, as well as girls, are more likely to have the illness. Women with poorly managed diabetes or who are obese are also more likely to have a kid with spina bifida.
Types
There are three main types of spina bifida:
Spina bifida occulta (SBO):
This is the most common and least severe type of the condition. Many people are completely unaware that they have it. ("Occulta" in Latin means "hidden.") The spinal cord and nerves are normally unharmed in this situation, however there may be a small gap in the spine. When people have an X-ray for another reason, they frequently discover out they have SBO. This kind of spina bifida usually does not result in any disabilities.
Meningocele:
The meninges (membrane protecting the spinal cord) protrude through the gap in this less common kind of spina bifida, causing a bulge or bag on the back. Meningocele is more severe than spina bifida occulta, yet it can still be treated surgically with little or no nerve damage. During infancy, the procedure can be done at any moment. The spinal cord in meningocele has developed normally and is unaffected. There are no neurological issues with the child.
Myelomeningocele:
The most severe form of spina bifida is myelomeningocele. The spinal cord does not form properly in an infant with a myelomeningocele, and a piece of the immature cord protrudes through the back. The projecting cord is surrounded by a sac holding cerebrospinal fluid and blood arteries, which is normally not covered by skin, exposing the nerves and tissues.
Because of a deformity near the base of the skull, between 70% and 90% of infants born with myelomeningocele also have hydrocephalus. If left untreated, hydrocephalus is a buildup of spinal fluid on the brain that can result in brain damage, convulsions, or blindness. Paralysis or weakness below the level of the spinal lesion is common in babies born with myelomeningocele.
Symptoms
A tuft of hair or a birthmark at the site of the lesion may be the most visible symptom of spina bifida occulta. The sac bulging through the infant's back is visible in meningocele and myelomeningocele. A thin layer of skin may cover the sac in the case of meningocele. There is frequently no skin covering with myelomeningocele, and the spinal cord tissue is exposed.
Other symptoms include:
l Weak leg muscles (in severe cases, the infant is unable to move his legs at all)
l Feet that are unusually formed, hips that are unequal, or a bent spine (scoliosis)
l Seizures
l Problems with the bowels or bladder
Breathing, eating, and moving the upper arms may also be difficult for children. They could also be overweight. The symptoms vary greatly depending on the location of the issue in the spine and which spinal nerves are affected.
Risk factors
Spina bifida affects more women than men, and it is more frequent in whites and Hispanics. Despite the fact that doctors and researchers are unsure why spina bifida arises, they have identified some risk factors:
Deficiency in folate.
Spina bifida and other neural tube defects can be caused by a lack of folate.
Neural tube defects run in your family.
Couples who have already had one kid with a neural tube abnormality have a slightly increased risk of having another child with the same issue. If two previous children have been diagnosed with the disease, the chance increases. Furthermore, a woman born with a neural tube abnormality has a higher risk of having a kid with spina bifida. The majority of babies born with spina bifida, on the other hand, come to parents who have no known history of the condition.
Some drugs are prescribed.
Anti-seizure drugs like valproic acid (Depakene), for example, appear to induce neural tube abnormalities when taken during pregnancy.
Diabetes.
Women with diabetes who don't have their blood sugar under control are more likely to conceive a kid with spina bifida.
Obesity.
Obesity before pregnancy is linked to a higher chance of neural tube birth abnormalities, such as spina bifida.
Body temperature has risen.
Elevating your core body temperature, whether through a fever or by using a sauna or hot tub, has been linked to a modest increase in the chance of spina bifida.
Diagnosis
Three tests can check for spina bifida
Blood test:
A sample of the mother's blood is examined to discover if it contains AFP, a protein that the baby produces ( Alpha- Feto-Protein). If the AFP level is abnormally high, the infant may have spina bifida or similar neural tube defect.
On a computer display, high-frequency sound waves bounce off tissues in your body, creating black-and-white images of the baby. You may notice an open spine or a sac bulging out of the spine if your baby has spina bifida.
Amniocentesis:
Your doctor may recommend amniocentesis if your blood test shows a high level of AFP but your ultrasound appears normal. This is when your doctor takes a little amount of fluid from the amniotic sac around your baby with a needle. If the fluid contains a high amount of AFP, it suggests the skin around the baby's sac is absent and AFP has leaked into the amniotic sac.
Treatment
Doctors can operate on infants as young as a few days old or even while still in the womb. If the newborn has meningocele, the surgeon will close the opening and replace the membrane around the spinal cord within 24 to 48 hours after birth.
If the newborn has myelomeningocele, the tissue and spinal cord will be placed back into the baby's body and covered with skin. In some cases, the surgeon will additionally insert a shunt into the baby's brain to prevent water from pooling on the brain (hydrocephalus). This is also done within the first 24 to 48 hours of the baby's birth. Following these procedures, more surgeries may be required to rectify abnormalities with the feet, hips, or spine, or to replace the brain shunt.
Progressive tethering occurs when the spinal cords of children with myelomeningocele become tethered to the spinal canal. This occurs in 20 to 50 percent of children with myelomeningocele. (The bottom of the spinal cord floats freely in the spinal canal in normal circumstances.) The spinal cord expands as the child develops, resulting in muscle atrophy and bowel or bladder issues. It's possible that surgery will be required to correct this as well.
Prevention
Any woman who is pregnant or attempting to conceive should consume 400 micrograms per day. If you have spina bifida or have a child with spina bifida, you should start taking 4,000 micrograms per day at least one month before you become pregnant and continue for the first several months of your pregnancy.
Dark green vegetables, egg yolks, and some fortified breads, pastas, rice, and morning cereals all contain folic acid.
Some Question related to spina bifida!
Can you develop spina bifida later on in life?
It's not uncommon to be diagnosed with Spina Bifida Occulta as an adult. This is considered a mild form of Spina Bifida, but for many, the lack of information, resources, and awareness can cause frustration.
Spina bifida curable?
There is no cure but most people with spina bifida lead long and productive lives. Scientists suspect genetic, nutritional, and environmental factors all play a role in spina bifida. People with spina bifida have different abilities and medical issues.
Which children are at risk for spina bifida?
Mother's age. Spina bifida is more common in teen mothers.
History of miscarriage. A woman who has had miscarriages in the past has a higher risk of having a baby with neural tube defects.
Does lack of folic acid cause spina bifida?
A folate deficiency increases the risk of spina bifida and other neural tube defects. Family history of neural tube defects. Couples who've had one child with a neural tube defect have a slightly higher chance of having another baby with the same defect.
Can a woman with spina bifida give birth?
In general fertility is not reduced in women with spina bifida and hormonal contraception is more difficult to perform due to an increased risk of thrombosis in paraplegia. Thus pregnancies of women with spina bifida are possible.
Does spina bifida run in families?
Most cases of spina bifida are sporadic, which means they occur in people with no history of the disorder in their family. A small percentage of cases have been reported to run in families; however, the condition does not have a clear pattern of inheritance.
Can you reverse spina bifida?
The damage to the spinal cord and nerves that occurs with Spina Bifida can't be reversed. Doctors typically operate within 48 hours of the baby's birth to prevent additional damage to the spinal cord and to prevent infection. The goal of surgery is to close the layers of tissue and skin over the spinal cord.
What foods prevent birth defects?
Preventing Birth Defects
Take a vitamin with 400 micrograms of folic acid every day.
Foods with folic acid include : okra, pinto beans, navy beans, mustard green s, kale, spinach, chicken liver, beef liver, orange juice, asparagus, broccoli, avocado, green peas, cauliflower, tomato juice, peanuts, and cantaloupe.
Does spina bifida affect the brain?
Many babies born with spina bifida get hydrocephalus (often called water on the brain). This means that there is extra fluid in and around the brain. The extra fluid can cause the spaces in the brain, called ventricles, to become too large and the head can swell.
Is spina bifida more common in males or females?
In most populations, spina bifida occurs more often among females than males
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