WHAT IS SPINA BIFIDA?
Spina bifida is a birth defect that occurs when a fetus’s backbone (spine) does not form as expected. The defect occurs during the early stages of pregnancy. The term “spina bifida” is a Latin phrase that means “open spine.” It is the result of incomplete closing of membranes around the spinal cord during a fetus’s initial development.
What Causes Spina Bifida?
Spina bifida may be the result of genetic and environmental factors. If a parent or sibling has the condition, there is around a 4-percent chance that an infant can develop the defect. (However, most children born with spina bifida have no known family history of the condition.)
The primary environmental factor that can cause the occurrence of spina bifida is the absence of folic acid (folate) before and during pregnancy. Folic acid plays a huge role in cell development, division, and tissue formation during pregnancy. For this reason, doctors recommend that women who expect to become pregnant take 0.4 milligrams (400 micrograms) of folic acid before pregnancy and continue this regimen throughout the first trimester. Women who are on antiseizure medications (e.g. valproic acid) or antidepressants may need to take much more folic acid. All women of childbearing age should eat a diet rich in folate, including green leafy vegetables, oranges, beans and lentils, melons, or eggs.
Less common causes of spina bifida may include maternal obesity and poorly managed diabetes.
What are the Different Types of Spina Bifida?
There are two main types of spina bifida: spina bifida occulta (closed back) and spina bifida aperta (open back). Furthermore, spina bifida aperta has two distinct categories: meningocele and myelomeningocele
- Spina bifida occulta – This is the mildest form of spina bifida, and it may go unnoticed and undiagnosed for years. Although the birth defect is present, it is hidden under the skin. While the spinal cord does not poke out from the location of the birth defect, the area may display a birthmark, hair patch, dimple, or groove. Beneath the skin, the spinal cord is typically attached to the surrounding tissue. Most cases of spina bifida occulta do not result in severe or ongoing health problems.
- Spina bifida aperta – This form of spina bifida is visible outside of the skin. It has two possible forms: meningocele or
- Meningocele refer to defective meninges (the membranes that protect the spinal cord and vertebrae). Meninges that push through vertebrae due to incomplete development can create fluid-filled sacs (called meningocele) along the spinal cord. Meningocele can be mild (the size of a grape) to severe (the size of a grapefruit). If the sacs press far enough into the nerves surrounding the spinal cord, the condition can cause problems ranging from poor bladder control to paralysis.
- Myelomeningocele is the most severe type of spina bifida and occurs when both the meninges and the bottom tip of the spinal cord push through an open hole in the spine. This results in a large fluid sac that protrudes from the baby’s lower back. The sac can also rupture during labor, dangerously exposing the spinal cord and nerves at birth. Because of associated nerve issues, myelomeningocele usually results in some form of paralysis, muscle weakness, and bone problems.
What is the Treatment for Spina Bifida?
Although there is no exact “cure” for spina bifida, there are varying treatment plans depending on the severity of the condition. Treatment for spina bifida tends to begin with surgery. For example, spina bifida occulta may need surgery if the spinal cord is “tethered” (attached to surrounding tissue). This surgery enables growth plate movement during growth spurts. Children born with a meningocele need surgery within the first months of infancy to push membrane back into the body and close the spinal opening. Finally, children born with a myelomeningocele need surgery within 48 hours after birth to close the opening and protect exposed nerve endings.
Following surgery, children with spina bifida generally need intervention and active therapy. Early childhood intervention can help with developmental milestones. Children with spina bifida may receive extensive physical therapy (including use of braces or stabilizers) to increase flexibility and range of motion along occupational therapy to increase gross motor capabilities. Children may also have access to a support system of neurosurgeons, urologists, orthopedic surgeons, and social workers. Contact The Warren Center for more information on intervention and therapy for children born with spina bifida.