Spina bifida is a common birth defect which affects the neural tube and central nervous system (brain and spinal cord). It commonly occurs in the first month of pregnancy due to incomplete development of the spinal cord and/or its coverings.
There are three variants of spin bifida:
Spina Bifida Occulta
The mildest form of spina bifida where the spinal cord and nerves are normal but there may be a small defect or gap between the vertebrae which typically does not cause any health problems.
This is a moderate form of spina bifida which occurs when the membranes of the spinal cord become enlarged and protrude leading to the creation of a cyst at the spinal opening. The defect is invisible through the skin and may not cause any problems.
The most severe form of spina bifida occurs when the spinal cord is exposed through the opening in the spine and results in neurological problems. Children with this condition may have partial or complete paralysis of the parts of the body that are below the spinal opening. Most infants born with this condition also have hydrocephalus (accumulation of fluid in and around the brain), problems with bowel and bladder control, and learning disabilities.
The exact cause of spina bifida is unknown. However, factors such as genetics, nutrition, radiation, and folic acid deficiency during early pregnancy may contribute to the development of spina bifida.
Children with spina bifida occulta exhibit no visible or physical signs of the condition.
A fluid filled sac is visible on the spine in meningocele and myelomeningocele. Defects are recognized as a small dimple, birthmark, or hairy patch at the site of the defect. In most severe cases of myelomeningocele the nerves and the tissues from the spinal cord become exposed.
Spina bifida which affects the spinal cord may cause problems such as an inability to control bowel movements, urinary incontinence, lack of sensation in the legs and feet, and partial or complete paralysis of the legs and less often in the arms.
Most cases of spina bifida can be diagnosed before birth with the help of prenatal tests such as ultrasounds, amniocentesis, and the alpha-fetoprotein (AFP) test. Postnatal diagnostic tests include x-rays, CT scans of the skull, and MRI and ultrasonography of the spinal area.
Treatment for spina bifida depends on a child’s clinical symptoms but most often includes physical therapy, antibiotics to prevent infection, and teaching the child bowel and bladder habits. Surgery is usually recommended at an early age and includes options such as spina bifida repair and ventriculoperitoneal shunting.