Thứ Hai, 13 tháng 1, 2014

Spina Bifida

Spina Bifida Spina bifida is a congenital (inherited by birth) that affects the growth of bones in the vertebral column. The child’s spinal cord does not form properly and sometimes makes it difficult for the child to walk or carry on with daily activities. Birth defect occurs on the neural tube which later develops into spinal cord and baby’s brain with the surrounding tissues.

The neural tube is the structure that forms before the end of first month of pregnancy and it closes shortly after formation. But in babies with spina bifida the neural tube fails to close normally causing defective bone growth on the spine. This condition occurs from mild to severe form of deviation and no treatment is available for treating spina bifida except surgery.

Types :

Spina bifida occurs in 3 types according to the range of severity namely occulta, meningocele and myelomeningocele.

Spina Bifida Occulta :

It is the more common type of deviation that occurs in the mildest form. Children with this type will not show any symptoms of defect unless a spinal cord X-ray is taken for other reasons. The children will not exhibit any signs of neurological problem in this mild type. In rare cases the skin above the spinal cord will show some defects like collection of fat, accumulation of tuft of hair, discoloration of skin in the back, and a small birthmark indication in that area.

Meningocele :

This type exhibits moderate range of deviation in which the protective membrane or tissues surrounding the spinal cord protrude out through a small opening seen in the vertebrae. This can be corrected by surgery without causing any damage to the nervous system or spine. It is a rare type of spina bifida affecting the children.

Myelomeningocele :

This type is the most severe one in which the baby’s spinal cord remains open on many vertebrae of the back. In this type, the membranes and the connective tissues and the spinal cord grows out of the baby’s back protruding at the back. It forms a big sac on the back portion of the child making him vulnerable to many infections.

This type of spina bifida would cause severe problems with the nervous system of the child like muscular weakness, paralysis (partial or full), seizures, bowel problem and many orthopedic issues like deformed feet and irregular hips making him difficult to walk.

Causes :

There is no concrete cause for inheriting spina bifida. Some believe that it can be passed on to the child through genes. Women who are obese and who are diabetic are more vulnerable to get a child with this disorder. But it occurs due to some wrong combination of genes and due to deficiency of folic acid.

This disease is common in certain race of people like Hispanics and Whites. Women with one child having neural tube defect have increased risk of having another child with the same defect.

Intake of certain drugs like valporic acid can cause serious neural tube defects during pregnancy. It can also be caused due to increased body temperature during the first trimester of pregnancy.

Symptoms :

The symptoms will be intense if the spina bifida appears on severe form. But there will not be any obvious symptom for the child with mild form of spina bifida. In moderate form, the child will have hairy patches on his back or a birthmark or a dimple on his back.

In severe form, the child will have intense nerve damage that makes him difficult to move his muscles on the legs. He cannot move many parts of the body that is controlled by spinal cord. Hence it will affect his daily life severely. In rare cases, there can be accumulation of fluid in the brain causing life threatening conditions. The child can get seizures, paralysis or even vision problem. He can get a curve (scoliosis) on his spine. Such children will usually develop intense allergy to rubber products like latex.

Diagnoses :

Fetal ultrasound test can detect the presence of spina bifida in the fetus. Further the pregnant woman can undergo amniocentesis test (removal of some amount of amniotic fluid through a needle) to confirm the disorder. After birth, any doctor can physically examine the baby to detect spina bifida. He would order for CT or MRI scan to assess the intensity of damage caused to the nerves. For some women, maternal blood sample is taken and tested for the presence of alpha fetoprotein MSAFP. If the levels are very high it indicates that the fetus has neural tube defect.

Treatment :

Treatment for spina bifida depends on the severity of the problem. For children with mild defect no treatment is required. However for children with severe form of disease surgery is done for correcting the nerve damage. During the surgery, the meninges (protruding tissues) are put back in place and the surgeon will close the opening of vertebrae.

For children with myelomeningocele surgery is to be done immediately after birth to reduce the risk of infection. The surgeon will push the spinal cord and tissues well inside the body of the baby and close them with the baby’s skin and muscle. Shunting is done to prevent accumulation of fluid in the brain.

Prenatal surgery is done during 26th week of pregnancy in which the surgeon cuts open the uterus for repairing the fetus spinal cord. Experts believe that it is good to correct the spina bifida before birth since it makes the baby vulnerable for high rate of infection and the disease would worsen rapidly. However prenatal surgery poses certain risk to the life of the baby and the mother.

Support is to be given by the parents and others for the child who has undergone corrective surgery for spina bifida. Ongoing care is absolutely necessary from therapists and physicians for treating other conditions like paralysis, bowel problems and seizures. The child should be given physiotherapy for preparing his legs to walk with the help of braces. Further surgeries are to be done for repairing and restoring certain vital functions.

Support and Coping :

For parents who have children with spina bifida in mild form nothing is going to change. Only for severe forms of this disease the children will face problem in walking and carrying out daily activities. Most of the children who have undergone corrective surgery can walk with the support of braces or splinters. They need the help of wheelchairs for covering long distances.

However the good news about spina bifida affected children is they have normal intelligence and hence there will not be any problem in learning. Basic physical disability will lead to emotional problem and hence parents and teachers should be supportive to the child. Number of support groups are available to offer help and counseling for the children affected with spina bifida.

Pictures of Spina Bifida :

Images, Pics, Pictures and Photos of Spina Bifida

Spina Bifida Spina Bifida Spina Bifida Spina Bifida
Prevention :

Nothing can be done to prevent the occurrence of spina bifida in your child. But every pregnant woman should take folic acid in recommended dosage during the first three months of pregnancy to reduce the risk of neural tube defects in the child. Taking extra dose of folic acid can help you to reduce the risk of having a child affected with spina bifida.

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