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Spina bifida explained

Monday, June 18, 2012    

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SPINA bifida is a birth defect that results in the incomplete development of the spinal cord or its coverings in developing babies. This usually occurs at the end of the first month of pregnancy when the two sides of the embryo's spine fail to join together, thus leaving an open area. Sometimes the spinal cord or other membranes may even push through this opening in the back.

Spina bifida is usually detected before a baby is born.

Dr Judy Tapper, paediatric neurologist at the Bustamante Hospital for Children, and who has offices on Hillcrest Avenue in St Andrew, said there are cases of babies being born with spina bifida in Jamaica, but she is unsure of the exact numbers.

While the causes of spina bifida are largely said to be unknown, Dr Tapper said women on certain medications while pregnant can cause the children to develop the condition.

There has also been stated a link with folic acid, and some research has shown that women who took folic acid months before becoming pregnant reduced the risks of defects like spina bifida. Therefore, the inclusion of folic acid is a major part of women's prenatal preparations worldwide.

It is also believed that high fever during pregnancy may increase a woman's chances of having a baby with spina bifida, while women with epilepsy who have taken certain medications to control seizures may have an increased risk.

The good news, Dr Tapper said, is that the condition can be treated, but it is usually done through surgery.

Spina bifida can be mild or severe. The mild form, known as spina bifida occulta, is the most common of three types, and usually does not cause problems or need treatment. In this condition, the defect is hidden as it is covered by skin and is not open. Most children with this condition never have health problems and the spinal cord is often unaffected. However, some children can have symptoms if the hidden defect is severe.

The severe forms are less common. These are meningocele and myelomeningocele.

In meningocele, fluid leaks out of the spine and pushes against the skin. A symptom may be a bulge in the skin, but in many cases, there are no other symptoms.

Although myelomeningocele is the most rare and severe form of spina bifida, it is the form most people mean when they say "spina bifida". In this condition, part of the spinal nerves push out of the spinal canal, and you may see a bulge in the skin. The nerves are often damaged, which can cause problems with walking, bladder or bowel control, and coordination. In some babies, the skin is open and the nerves are exposed. This too can be closed through surgery.

Because of the abnormal development of and damage to the spinal cord, a child with myelomeningocele typically has some paralysis, with the degree largely depending on where the opening occurs in the spine. The higher the opening is on the back, the more severe the paralysis tends to be.

Children with spina bifida often have problems with bowel and bladder control, and some may have attention deficit hyperactivity disorder or other learning difficulties.



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