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Spina bifida

Spina bifida

Spina bifida

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. Derived from Latin, spina bifida means split or open spine.

Types of spina bifida

Spina bifida occulta – Known as the mildest form of spina bifida, it is often referred to as hidden spina bifida, and is a small gap or separation in one or more of the bones, or vertebrae of the spine. Since the spinal nerves are not involved, most children exhibit no signs or symptoms.

Meningocele – This form of spina bifida is where the tissue covering the spinal cord sticks out of the spinal defect but the spinal cord remains in place.

Myelomeningocele – Also known as open spina bifida, myelomeningocele is the most common and severe form of spina bifida. Myelomeningocele is when the newborn’s spinal canal remains open along several vertebrae in the lower or middle back. The membranes and the spinal cord push out because of this opening; a sac is formed on the newborn’s back.

Signs of spina bifida

Symptoms of spina bifida vary in each case, depending upon the severity, and may include:

  • An abnormal tuft of hair
  • A collection of fat
  • A small dimple or visible birthmark on the newborn’s skin above the spinal defect
  • A fluid filled sac sticking out of the mid to lower back
  • Partial or complete lack of sensation
  • Partial or complete paralysis of the legs
  • Weakness of the hips, legs or feet of a newborn; abnormal feet or legs such as clubfoot
  • Build up of fluid inside the skull, known as hydrocephalus

Diagnosing spina bifida

The cause of spina bifida is unknown. Prenatal testing can often help diagnose spina bifida in your child. 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:

  • Pregnancy ultrasound The ultrasound is a real-time scanner that shows the continuous movement of the fetus and structural abnormalities in the fetus can be reliably diagnosed by an ultrasound scan.
  • Amniocentesis – Amniocentesis is a prenatal test where a small amount of amniotic fluid, which contains fetal tissue, is collected from the amniotic sac surrounding the developing fetus through a needle to determine any genetic disorders.

Treatment of spina bifida

The type of treatment may vary depending on the type and severity of spina bifida your child has and plans of treatment will be discussed with you by your doctor or team of doctors. It is important to keep in mind that each case is unique and treatment will be specific to your child’s needs.

The types of treatment for spina bifida may include:

  • Surgery (this can be ongoing depending on the severity)
  • Medications
  • Physical therapy
  • Occupational therapy

Children diagnosed with spina bifida meningocele may develop complications such as bladder issues and hydrocephalus, which may require surgery. Many newborns with myelomeningocele develop hydrocephalus, which can be drained through the surgical procedure that uses special tubes, or shunts.

Children with myelomeningocele may develop further spinal cord issues where the vertebrae and spinal cord do not stretch and experience normal growth as they grow. This may cause loss of muscle function in the bowel, bladder and legs. Surgery on the spinal cord may be required to help restore function.

Some children may need subsequent surgeries to manage issues with their feet, hips or spine.

Children with myelomeningocele spina bifida generally require surgery to correct the spinal defect or prevent further injury or trauma to the exposed spinal cord and nerves. Surgery can also help in the prevention of infections.