What is Spina Bifida - Causes, Symptoms, and Treatment

Spina bifida is a condition where a baby takes birth with spinal deformity along with some damaged nerves and tissues. Nevertheless, there are also other types of this medical condition. Here is all you need to find about what spina bifida is, along with its types, symptoms, treatment procedures and so on.

Spina bifida is a medical condition in which the spine does not develop properly in the prenatal stage of a baby. As a result, its formation becomes defective after birth. This medical condition is also known as a neural tube defect or NTD.

In normal conditions, the neural tube of an embryo develops and becomes the spinal cord, brain and surrounding tissues. It forms in a foetus at an early stage of conception, and this process ends within the 28th day of conception.

However, this neural tube does not form and, as a result, does not remain closed properly in babies who suffer from spina bifida. It does not get the protection of the backbone as it normally should, causing damage to nerves and spinal cords. It can also lead to intellectual and physical disabilities during growth.

Following are three common types of this condition:

• Myelomeningocele: It is the most severe medical condition of spina bifida. In myelomeningocele, a sac of fluid forms on top of the back through an opening. It gives a bulging shape on the back. This sac contains deformed or damaged nerves and spinal cords. Myelomeningocele can lead to medium to severe disabilities due to nerve damage. In most cases, babies lose the ability of using their legs and feet completely.

• Meningocele: Like myelomeningocele, meningocele also leads to the formation of sacs on an individual’s back. However, this sac does not include any part of the spinal cord. In fact, in this type of spina bifida, almost zero to very less nerve damage can be observed. As a result, it results in minor disability.

• Spina Bifida Occulta: It is a mild medical condition of spina bifida with a very small spinal gap. However, unlike the former two types, you cannot observe any bulging sac on a patient's back. Therefore, it does not cause any disabilities. In fact, symptoms can remain unnoticed even till adulthood.

The spina bifida symptoms can vary from one type to another, as mentioned below:

1. Symptoms of Myelomeningocele

Signs of this type of spina bifida are:

• Exposed sac on the back
• Open canal of the spine, usually on the lower or middle portion of the patient’s back
• Paralyzed or weak muscles of legs
• Deformed feet
• Seizures
• Uneven hips
• Curved spine
• Bladder and bowel issues

2. Symptoms of Meningocele

Following are the signs of meningocele:

• A visible sac on the back
• Small opening of spine on the back
• Membranes inside the sac jutted out through vertebrae

3. Symptoms of Spina Bifida Occulta

Here are the signs of the spina bifida occulta:

• A small gap within the vertebrae
• No observable opening from outside
• A dimple or a birthmark and on the back
• A small group of hair coming out from a point on back
• Extra fat in a particular area of the back

It is very difficult to understand whether an individual has spina bifida occulta as the symptoms are not much pronounced.

You cannot attribute one particular factor that causes spina bifida in a child. Nevertheless, the following aspects in the mother increase the risks of developing this disease in the baby:

1. Deficit of Folic Acid (Vitamin B9)

A lack of folic acid within a pregnant woman’s body may lead to the development of spina bifida in her baby. This vitamin is essential to support the required biochemical reactions within the body. According to experts, if a woman takes folic acid supplements before and after conceiving, she can reduce the risk of spinal tube defects in her children by nearly 70%.

2. Family History

If you have a family history of a neural tube defect, like spina bifida, there is a chance that your child may also be born with this disease. You should also be careful if you already have a child with this medical condition. Under such a scenario, your general physicians may instruct you to take folic acid supplements long before your pregnancy.

3. Medicine

Certain medicines have a connection with the causes of spina bifida within a baby. Among these, the drugs used for epilepsy and psychological health conditions, such as carbamazepine and valproate, are to name a few. Generally, doctors refrain from prescribing these medicines when someone is planning to have a baby soon.

Apart from these, obesity and diabetes in a mother are also risk factors that increase the chance of spina bifida in a child.

Doctors can diagnose the spina bifida of your child both during pregnancy and after birth.

1. During Pregnancy Diagnosis

You need to know that the prenatal screening of a mother may produce incorrect results. A child may be born without spina bifida despite the prenatal diagnosis showing positive signs of the medical condition or vice versa. Following are some diagnoses of this illness:

• Maternal Serum Alpha-Fetoprotein or MSAFP Test: Alpha-Fetoprotein is a chemical substance a baby produces in its prenatal growing stage. It is very unlikely for this to get out from the placenta and mix with a mother's blood. By conducting the MSAFP test, doctors estimate the presence and the extent of AFP in the mother’s blood. A high amount of this indicates that there is a chance of neural tube defects in the baby.
• Ultrasound: Ultrasound helps create a clear image of a baby's body using sonography technology. Generally, doctors perform this after the first and second trimesters. It can help doctors to understand the development of spina bifida accurately.
• Amniocentesis: In this process, doctors will collect samples of amniotic fluid from the mother's womb. If the AFP level is higher within this fluid, the risk of spina bifida increases.

2. After Birth Diagnosis

As mentioned, sometimes it becomes difficult to know whether a baby is born with this medical condition, especially in the case of spina bifida occulta. Therefore, when there are symptoms like dimples and hairy patches on the back of a baby, doctors perform X-Ray, MRIs and CT scanning to ensure whether a baby has this illness.

Medication, surgery and physiotherapy are some of the treatment procedures that doctors may perform according to the complications of a patient.

Following are some of the spina bifida treatment processes:

1. Surgery Immediately after Birth

Surgery can help in repairing the affected spine. In babies with this disease, a part of the spine and nerves gets out of the back and remains coiled within a sac. Doctors remove this sac through surgery immediately within 48 hours of the delivery of the baby. It reduces the chances of further complications.

During this operation, surgeons take necessary measures so that the deformed spinal cords go to the right place. They fill any gap in the spine with skin and muscles. Nevertheless, you need to know that the nerves damaged by spina bifida are non-curable.

There are also prenatal surgical processes to cure spina bifida when the baby is inside the womb. You may need to contact your doctor to know the risk and benefits of this prenatal surgery.

2. Physiotherapy

Physiotherapy is a follow-up treatment process. It helps patients with the movement of muscles. It also ensures that they do not lose the strength of their muscles, thereby preventing deformity. The treatment process includes routine exercises. Physicians also help patients get habituated with splints supporting their leg performances. Further, with mobility training in this therapy, doctors try to rectify and improve patients’ bowel movements and bladder functions.

3. Occupational Therapy and Mobility Aids

Occupational therapy gives patients training for dealing with regular activities so that they do not need to be dependent on others. For example, patients learn to get dressed, handle the necessary equipment, etc. Apart from occupational therapy, mobility aids like a wheelchair, splints, braces, etc., helps them move from one place to another if they have poor leg strength.

4. Medications

Doctors may prescribe medicines along with antibiotics to rectify urination problems and ensure proper functioning of the bladder. Furthermore, patients with improper bowel movements also need to intake laxatives to get relief from constipation.

5. Complication Specific Surgeries

Doctors also perform the following surgeries if necessary:

1. Treating Bowel Problems: Through the colostomy, surgeons connect a pouch with the end of the large intestine so that it can collect stool.
2. Treating Bladder Problems: Surgeons enlarge the bladder through operation to enhance its capacity of holding urine.
3. Treating Hydrocephalus: Surgeons insert a shunt or a thin tube to pump out excess fluid from the brain.

Here are some tips that a woman can follow during her pregnancy for the prevention of spina bifida in her baby:

• Take folic acid every day as recommended by your physician. You may need to intake 400 micro milligrams of this vitamin every day. Further, the amount may increase if you already have a child with spina bifida.
• You should ideally keep your physician informed about over-the-counter medicines, supplements or vitamins you have been taking.
• Make sure to control existing medical conditions, especially obesity and diabetes, before trying for a baby.
• Avoid a physical environment that can overheat your body. You also need to ensure that you do not have a fever.

Since the myelomeningocele and meningocele spina bifida are easily observable immediately after the birth of a child, you will get medical attention right from the hospital. You will get the necessary advice according to your child's medical condition. The treatment of your child may continue throughout their lifetime.

Nevertheless, if it is spina bifida occulta and you can observe its symptoms, you should ideally take your child to an expert physician and get the necessary diagnoses. This way, you can ensure that your child gets the required medical attention quickly.

Now that you properly know what spina bifida is and its possible complications, you can understand the necessity to maintain preventive measures before you try for a baby. Spina bifida develops within your child's body while it is still a foetus, mostly within the first few weeks of conceiving. Therefore, you need to stay physically fit and control your diabetes and body weight during that period.