In Latin, the words spina bifida mean “split spine”. The Spina Bifida Association defines Spina Bifida as” the most common permanently disabling birth defect in the United States…happens when a baby is in the womb and the spinal column does not close all of the way.” Each day, around eight babies are born with Spin Bifida or a similar birth defect to the brain and spine. Over 166,000 individuals across the United States have Spina Bifida.
There are several different classifications of Spina Bifida that include; Occult Spinal Dysraphism (OSD), Occulata, Cystica, Menifesta, and Aperta. The different types of classifications are identified based off of the symptoms that are present in the individual. Each type has different levels of severity and the physical limitations are usually on a case by case basis.
Occult Spinal Dysraphism in infants can be shown by a dimple in their lower back, red marks, tufts of hair or small lumps. Doctors have to run special tests to diagnose correctly. If OSD isn’t treated the spinal cord can grow the wrong way and cause problems for the child as they grow.
Spina Bifida Occulata “occurs with normal meninges and normal elements. There is no protrusion of meninges and spinal cord and defect is covered by muscles and skin. It is of no clinical significance because it does not show any symptoms.” This classification is not clinically significant because it doesn’t show any major symptoms other than tuft of hairs may be present in defective sites. This is often called “hidden Spina Bifida” due to symptoms not always being present. 15% of healthy people have it without even knowing it.
Spina Bifida Cystica will have swelling present at the site and it has two sub-variants. The two sub-variants are Spina Bifida Cystica with meningocele and Spina Bifida Cystica with myelomeningocele. Meningocele “causes part of the spinal cord to come through the spine like a sac that is pushed out.” There is usually no nerve damage but people with this condition may have minor disabilities. Myelomeningocele is the most severe form of Spina Bifida because nerves and parts of the spinal cord come through the open part in the spine. “70 to 90% of children with this condition also have too much fluid on their brains.” Without treatment a persons head can swell because the fluid that protects the brain can not be drained due to the spinal cord being unable to drain it. This can cause nerve damage, disabilities, and brain damage.
The last two are Spina Bifida Menifesta, the symptoms of this are hemangioma, hair, sinus, tract, and covered or open neural elements. There is also Spina Bifida Aperta where there is a complete aperture at the defective site. The site will usually be covered by reddish, semi-transparent, oozing membrane that merges into surrounding skin.
No one knows what the cause is for sure. Scientist believe that genetic and environmental factors act together to cause the condition. They do know that it happens during the first month of pregnancy. The tissues that fold to form the neural tube don’t close or stay closed and that is what causes Spina Bifida. One thing that may help to prevent this from happening to children would be women taking folic acid before and during the first three months of pregnancy. It is also stated that “Women who have a child or sibling with Spina Bifida, have had an affected pregnancy or have Spina Bifida themselves should take 4000 mcg (4.0 mg) of folic acid for one to three months before and during the first three months of pregnancy.” Folic acid is a vitamin that just helps the body to grow and be healthy. It can be found in several different foods but it is easier for our bodies to absorb it if it is taken in the form of a pill.
Even though they aren’t sure of the cause they have found different ways to treat it. If a child has Meningomyelocele they are usually going to be operated on within two to three days of birth. By doing this it helps to prevent more damage from happening to the spinal cord and helps to prevent infections. If a child is born with Meningocele they usually treat them with surgery. The children are usually not paralyzed and they should grow up fine but they should still have check ups with their doctor because it they may have other serious problems that are not seen. A child with OSD should see a surgeon because it is believed that the earlier it is treated the more likely it will keep nerves and the brain from becoming more damaged with age. Some other treatments include ventricoperitoneal shunt, bladder and urinary tract management and fetal surgery with stem cells.
Spina Bidifa can also be detected before birth if a mother was wanting to check. They can be tested with a blood test during the 16th to 18th week of pregnancy. It is known as and AFP (alphafetoprotein) screening test. They can also test by taking an ultrasound of the fetus or aje a test where a small amount of fluid from the womb is taken through a thin needle. The name for the fluid test is called maternal amniocentesis and shows the different protein levels. However, these tests are not always accurate.
Some different consequences include brain malformations, spinal cord abnormalities, latex allergies, breathing problems, pressure ulcers, urologic abnormalties, cardi-metabolic dysfunction, mobility, bladder, bowl, gastrointestinal disorders, obesity, skin breakdown, learning disabilities, social issues, tendonitis, and sexual issues. Often people with Spina Bifida must learn how to get around by sing crutches, braces, or wheelchairs. It is important for adults to learn what the child can and can’t do so that they help them the right amount. If they receive too much help it may prevent them from being able to learn the independence they need in order to improve. Children with Spina Bifida can lead full lives with the right help.
One of the organizations that help with Spina Bifida would be the Spina Bifida Association. The mission statement of the Spina Bifida Association is “to promote the prevention of Spina Bifida and enhance the lives of all affected.” This organization has helped millions of people receive information about Spina Bifida and how it affects the individuals that are born with it and live with it. It makes supportive relationships by letting people have this disability connect with each other. Their outreach campaign has also taught women the importance of taking folic acid prior to pregnancy to reduce the risk of Spina Bifida.
References
Iqbal, M. A., Chaudhary, M. Z., Abbas, M. W., Maqsood, F., Fatima, F., & Iqbal, M. N. (2016). Spina Bifida; The Basic and Clinical Review. Spina Bifida; The Basic and Clinical Review,23(8). Retrieved February 14, 2018, from ebscohost.com.
Recreation. (n.d.). Retrieved March 04, 2018, from http://spinabifidaassociation.org/resource-directory/recreation/
Spina Bifida. (n.d.). Retrieved February 14, 2018, from http://www.mychildwithoutlimits.org/understand/spina-bifida/