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Spina bifida (“cleft spine”) – types, causes, symptoms, diagnosis, prevention and treatment

Spina bifida is a birth defect of the spine (backbone). Spine consists of spinal chord which is like a closed tube made up of nerves. Babies with spina bifida have an opening in the tube because it
has not completely closed. It happens during first month of pregnancy.
A spinal cord that’s damaged may not be able to do the important job of getting messages to and from the brain. These messages may not be able to get through if a person has spina bifida.

Different types of Spina Bifida
Every unborn baby’s spine is open when it first forms, but it normally closes by the 29th day following conception. In Spina Bifidas, the backbone never closes completely. There are four types of spina bifida:
– Occulta: In this, one or more vertebrae are malformed. The opening in the spine, is covered by a layer of skin.
– Closed neural tube defects: These are spinal defects in which the spinal cord is marked by a malformation of fat, bone, or membranes. It can cause incomplete paralysis with urinary and bowel dysfunction.
– Meningocele: The meninges protrude from the spinal opening, and the malformation may or may not be covered by a layer of skin.
– Myelomeningocele: The most severe condition and occurs when the spinal cord is exposed through the opening in the spine, resulting in partial or complete paralysis of the parts of the body below the spinal opening.

Causes of Spina bifida

– Folic acid deficiency.
– Genetics also seems to play a role.
– Spina bifida also can occur as part of a syndrome with other birth defects.

Symptoms of Spina Bifida

– Protrusion on the mid to lower back of the new born.
– Weakness of the hip, leg or feet of a newborn.
– Tuft of hair at the sacral area (back part of the pelvis) or dimpling of the sacrum.

Complications of Spina Bifida

Complications of spina bifida can range from minor physical problems to severe physical and mental disabilities. Severity is determined by the size and location of the malformation, whether or not skin covers it, whether or not spinal nerves protrude from it, and which spinal nerves are involved.
– Loss of sensation and paralysis, another neurological complication.
– A rare condition Chiari II malformation in which the brainstem and the cerebellum, or rear portion of the brain, protrude downward into the spinal canal or neck area. This condition can lead to compression of the spinal cord and cause a variety of symptoms including difficulties with feeding, swallowing, and breathing; choking; and arm stiffness.

Diagnosis of Spina Bifida

– A screening blood test, called an alphafetoprotein test (AFP), is done using the pregnant mother’s blood when she is about 15-17 weeks into the pregnancy.
– If the results are abnormal, a detailed (Level II) ultrasound is done which can show the presence of spina bifida.
– An amniocentesis (sampling of the amniotic fluid in the womb) may be done to recheck the AFP level or do other tests.

Prevention of Spina Bifida

– Folic acid can help prevent spina bifida before your baby is born.
– Women should realize that it is important that they consume the vitamin every day, whether they are planning a pregnancy or not.

Treatment of Spina Bifida

There is no cure for SB because the nerve tissue cannot be replaced or repaired.
– Treatment for the variety of effects of SB may include surgery, medication, and physiotherapy.
– The opening in the spine can be closed surgically either before or after birth, and this will reduce its effects on the body.

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