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Understanding spina bifida

Understanding spina bifida

Shriners Hospitals for Children — Greenville's physicians provide specialized care to almost 300 patients affected by spina bifida each year. Spina bifida is part of a group of birth defects known as “neural tube defects”. The neural tube is the embryonic structure in the fetus that eventually becomes the baby’s brain and spinal cord, as well as the tissues that enclose them.

Normally, during the first two months of a pregnancy, the backbone joins together to cover the baby’s spinal cord, spinal nerves and meninges, the tissues covering the spinal cord. In children diagnosed with spina bifida, a section of the neural tube fails to develop or close properly, causing defects in both the spinal cord and backbone. Presenting in three different types, a child can have spina bifida occulta, meningocele or myelomeningocele, all of which vary in severity.

While the cause of spina bifida is unknown, prenatal testing can often help diagnose the condition in a fetus. During the second trimester, pregnant women can have a blood test called the quadruple screen. This test screens for myelomeningocele, Down syndrome and other potential congenital diseases. If the test is positive, additional tests can include an ultrasound or amniocentesis, which will determine any genetic disorders.

At the Greenville Shriners Hospital, physicians can meet with parents and develop a plan for treatment before a baby diagnosed with spina bifida is delivered. Just as the types of the condition vary, treatment plans also greatly vary and are specific to each child’s needs. Options to improve quality of life may include surgery, medications and physical and occupational therapy.

Surgery is performed on patients with both spina bifida meningocele and myelomeningocele. Children diagnosed with spina bifida meningocele may develop complications such as bladder issues and hydrocephalus (the buildup of fluid in the cavities deep within the brain), which may require surgery. Many newborns with myelomeningocele also experience excess brain fluid, which can be drained through a surgical procedure that uses special tubes, or shunts.

With myelomeningocele, children may develop further spinal cord issues where the vertebrae and spinal cord do not stretch and experience normal growth as the child grows. This may cause loss of muscle function in the bowel, bladder and legs, and may lead to surgery on the spinal cord to help restore function.

Furthermore, patients with myelomeningocele spina bifida generally require surgery to correct the spinal defect or prevent further injury or infection in the exposed spinal cord and nerves.

As spina bifida patients mature, they are continually cared for by a multidisciplinary team that help them manage their condition and live their best possible lives.

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