Your baby’s risk for Spina Bifida

SPINA Bifida is a Latin term literally translated to mean split spine, used to describe an embryonic neural tube defect which occurs during the early embryological development.

“Spina Bifida is the most common birth defect of the central nervous system involving the incomplete closure of the tube that forms the spinal cord and column,” said Dr Anona Griffith, paediatrician at Gateway Plaza in Old Harbour.

She explained that during the development of a baby, the nervous tissue in the brain and spinal cord begin as a group of cells that resemble a plate that rolls together to form what is known as the neural tube. She noted that as it matures, it becomes differentiated to form the brain, spinal cord and the coverings of both soft tissues and bone of the spinal column.

“There are four described types of the defect. They vary in severity and disability, with mild forms being associated with little or no disability and the more severe with greater levels of disability which can include not only physical but intellectual disability,” Dr Griffith explained.

She said the dysfunctions associated with this condition usually include the bladder, bowel, back and lower limb problems such as paralysis.

“Knowledge of the extent of the child’s disability can generally be identified by the level at which the defect is located along the spinal cord. This can be anywhere along the cord, and from this point downward the cord is usually damaged,” Dr Griffith said.

Below, Dr Griffith explains the four deficits:

1. Spina Bifida occulta (hidden)

Spina Bifida occulta (hidden) is the most common and mildest form of the disease.

“This form of the disease is usually not obvious to the naked eye as it is covered with skin, but there may be a dimple or patch of hair at the site of the defect; however, there may be no associated symptoms,” Dr Griffith said.

2. Meningocele

“This form is uncommon and involves the protrusion of the brain coverings, through the opening in the vertebrae,” Dr Griffith said. This, however, is treatable with surgery.

3) Myelomeningocele

“This form is often what is termed as Spina Bifida. This is the most severe form in which there is a protrusion of the spinal cord and its coverings through the defect. This type sometimes has associated brain abnormalities such as hydrocephalus and Arnold-Chiari malformations,” Dr Griffith explained. She also pointed out that with this significant damage to the spinal cord, the nervous system is compromised and becomes more vulnerable to life-threatening infections.

4. Lipomyelomeningocele or lipomeningocele

Dr Griffith said this type typically refers to a lesion which involves fatty tumours.

But what causes this sometimes debilitating and life-threatening condition?

“The causes of Spina Bifida are multiple and complex. They include genetic or inherited as well as environmental factors. The main dietary contributor to Spina Bifida has been found to be a deficiency of folic acid,” Dr Griffith said.

She warned that illnesses such as this one should send a message to women desirous of becoming pregnant to begin to adhere to dietary recommendations for even before pregnancy, and to ensure that they remain committed throughout their pregnancies.

The abnormality occurs in the early part of pregnancy but is usually detected in the second trimester with screening during ultrasounds and special blood tests looking for abnormal levels of a protein called alpha-fetoprotein.

Treatment, according to Dr Griffith, is dependent on each case.

“This is a multidisciplinary approach because of the many areas that may be affected. So first, the prognosis associated with this condition is dependent on the extent of spinal cord damage. But once a child is delivered, the aim of treatment is to prevent infection and protect the exposed tissues.”

She also noted that an in-utero surgery is done at specialised centres with the aim of preventing further neurological damage.