Spina Bifida (SPY-na BIF-i-da) or myelomeningocele
(MY-eh-lo-me-NING-oh-seel )
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Spina bifida is one of the most common birth defects that
involve the nervous system and it may affect as many as 1 in 800
infants. Yet the cause of Spina Bifida is still unknown.
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Spina bifida is a birth defect that involves the incomplete
development of the spinal cord or its coverings. The term spina
bifida comes from Latin and literally means "split" or "open"
spine.
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Date updated: February 20, 2008 Content provided by KidsHealth
At about the 5 th week in the pregnancy the embryos distinct shape
begins to form. The early stage of the development of the heart is
seen, and the neural tube, which will eventually form into the
spinal cord and brain, runs from the top to the bottom of the
embryo.
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The neural tube is the part of a developing fetus that grows
into the spinal cord and brain. Normally, the bones of the skull
and spine grow around the brain and spinal cord, and then skin
covers the bones, creating the neural tube.
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Spina bifida occurs when the two sides of the embryo's spine
fail to join together, leaving an open area. This is called neural
tube defect, or NDT.
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A neural tube defect (NTD) is a birth defect that occurs when
the spine, the brain, or the bone and skin that protect them do not
develop properly. Spina bifida is the most common type of neural
tube defect. Anencephaly is another type of NTD.
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Occulta : the mildest form of spina bifida (occulta means
hidden). Most children with this type of defect never have any
health problems. The spinal cord is often unaffected. Manifesta:
includes two types of spina bifida, meningocele and
myelomeningocele.
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MENINGOCELE ANDMYELOMENINGOCELE Meningocele involves the
meninges, the membranes responsible for covering and protecting the
brain and spinal cord. If the meninges push through the hole in the
vertebrae (the small, ring-like bones that make up the spinal
column), the sac is called a meningocele. Myelomeningocele is the
most severe form of spina bifida. It occurs when the meninges push
through the hole in the back, and the spinal cord also pushes
though. Most babies who are born with this type of spina bifida
also have hydrocephalus, an accumulation of fluid in and around the
brain.
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Because of the abnormal development of and damage to the spinal
cord, a child with the myelomeningocele form of spina bifida
typically has some paralysis. The degree of paralysis largely
depends on where the opening occurs in the spine. The higher the
opening is on the back, the more severe the paralysis tends to
be.
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Neural tube defects can be detected with prenatal tests, such
as ultrasound and amniocentesis Amniocentesis: Transabdominal
puncture of the amniotic sac using a needle and syringe in order to
remove amniotic fluid to be studied for any disorders.
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In spina bifida, treatment depends on the severity. Children
with spina bifida occulta usually need no treatment. In cases of
spina bifida manifesta, the treatment largely depends on the type
of spina bifida a child has and how severe it is. A child with the
meningocele form of the disease usually has an operation during
infancy in which doctors push the meninges back and close the hole
in the vertebrae. Many children with this type of spina bifida have
no other health problems down the road, unless there is nerve
tissue involved with the sac..
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Babies born with the myelomeningocele form typically have
surgery within the first 1 to 2 days of their lives. During this
first surgery, doctors typically push the spine back into the
vertebrae and close the hole to prevent infection and protect the
spine. A baby who also has hydrocephalus will need an operation to
place a shunt in the brain. The shunt is a thin tube that helps to
relieve pressure on the brain by draining fluid.
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In addition, some children need surgeries to manage problems
with the feet, hips, or spine. The location of the gap in the back
often dictates what kind of adaptive aids or equipment that a child
with myelomeningocele will need down the line. Children with a gap
high on the spinal column and more extensive paralysis will often
need to use a wheelchair to move around, whereas those with a gap
lower on the back may be able to use crutches, leg braces, or
walkers. People with spina bifida most likely also have to deal
with incontinence.
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Adequate intake of certain nutrients, such as folic acid,
protein, calcium, and iron is essential prenatal nourishment for
the baby. Based on past studies, the lack of folic acid has been
determined to be a primary cause for the birth defect of Spina
Bifida. In 1992, the FDA recommended fortifying the nations food
supply with folic acid, a strategy that has worked well in the past
with other beneficial substances including iodine (in salt),
vitamin D (in milk), and thiamin (in flour and bread). Folic acid
began being added to breads and other grain products in January of
1998.
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Folate is a B vitamin which is found naturally in leafy
vegetables, citrus fruits, beans, and whole grains. Folate and
folic acid are interchangeable terms; folic acid is the synthetic
form of folate. Scientists are in general agreement that folic acid
reduces the risk of neural tube defects.
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Maternal folic acid deficiency has also been linked to spina
bifida, and researchers believe that many cases of spina bifida
could be prevented if women of childbearing age consume 0.4
milligrams (400 micrograms) of folic acid every day, and continue
to take it throughout the first trimester. Good sources of folic
acid include eggs, orange juice, and dark green leafy vegetables.
Many multivitamins contain the recommended dose of folic acid as
well. Michael A. Alexander, MD, KidsHealth
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Men with relatively low levels of folate had increased risks
for sperm containing either too few or too many chromosomes,
according to researchers at the University of California, Berkeley.
These types of deficiencies can cause birth defects and
miscarriages, the experts noted. According to an article from
HealthDay News
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Doernbecher Children's Hospital Here in Oregon .Spina Bifida
Clinic Clinic activities include prevention through case finding,
diagnosis, and evaluation. The team makes recommendations to
primary care physicians regarding intervention, long term
management, and coordination of care. The program primarily serves
children and young adults from birth through age 21. However,
people with neural tube defects may be referred to the program at
any age. The program counsels families who have had a prenatal
diagnosis of neural tube defect to help prepare the family for
delivery, infant care, and ongoing management.
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Hank Williams Jr.John Cougar Mellencamp Jean Driscoll, Olympian
Just to name a few.
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W W W. S B A A. O R G There is support right now for people
with Spina Bifida, and a future for them, because of the research
going on that is trying to solve the handicap issues they face. Go
to the following web site to find out more information.
