Types of Spina Bifida Defects

About Types of Spina Bifida

A birth defect or series of birth defects that can potentially affect the spine and central nervous system development, severe forms of spina bifida can affect up to 1 in 800 infants. The actual majority of children who are affected do not have any perceivable problems from this disorder, however, because it is usually only present in a mild form.

Spina bifida occurs when vertebrae surrounding the spine do not form properly, leaving the spinal cord exposed. This may affect how skin on the baby’s back looks, or could affect nerve cell function in more severe cases.

Definition of Spina Bifida

Ordinarily in the first month of a pregnancy, the vertebrae of the embryo’s spine will join together in order to form a covering for the delicate spinal nerves, tissues, and spinal cord. This initial structure is called the neural tube, before it fully develops. However, when these two sides of the spine do not form a complete closure, this is referred to as spina bifida, which means “split spine” in Latin.

Types of Spina Bifida

There are three main types of spina bifida which are important to take into consideration. Not all children will have the severe symptoms that many may associate with this disorder, such as difficulty walking or paralysis. In many cases, the only symptoms will be a slight dimpling of the skin in the back. It’s important to look at all three types in order to understand more about what is spina bifida.

1. Spina Bifida Occulta

The most minor type of spina bifida is spina bifida occulta, in which the spinal opening is extremely small. In most cases, there is a gap in the vertebrae, but this will be covered with skin so that the gap is not apparent from the outside. There are usually no symptoms, and those who have this form of the disorder will not even know that they have it unless they discover it by chance, such as when going to the doctor for a spinal x-ray for other reasons.

Although there are usually no symptoms and thus no treatment required, at times the following may be apparent:

  • Bladder and bowel movement problems
  • Scoliosis
  • Dimpling of the skin
  • Birthmarks

2. Spina Bifida Meningocele

The rarest type of spina bifida, spina bifida meningocele occurs when the membranes or protective tissues surrounding the spinal cord, known as meninges, are pushed out through vertebrae openings. With a simple surgical treatment, these tissues can be removed in most cases. There is no impact on the nervous system, and as a result there will be no symptoms in most cases.

3. Myelomeningocele

The most serious type of spina bifida, that is usually what people think of when they hear the name of this condition, is myelomeningocele. Although it is rare, it can be a severe condition causing damage to the nervous system. In this case, the spinal column will be open along several vertebrae in a row, rather than just one or two. The spinal cord and its surrounding membranes may push out of the body to create a sac poking out of the baby’s back.

This can lead to infections in the nervous system, which is a severe side effect of this condition. Surgery may be necessary to close the spinal opening. However, if damage to the nervous system has already occurred, there may be a slew of symptoms that accompany this. Some of these include:

  • Paralysis of the lower limbs
  • Loss of sensation in the skin
  • Urinary or bowel incontinence
  • Hydrocephalus or excessive fluid surrounding the brain

In the case of this final symptom, which is caused by problems with development in the embryonic neural tube, surgery will be necessary. If left untreated, severe brain damage, including retardation, can occur as a result.

How Spina Bifida is Diagnosed

Because there are these three types of spina bifida, two of which can potentially have no visible symptoms, diagnosis can be tricky. One of the main ways to determine whether or not an infant has spina bifida is to test the mother while she is still pregnant. With a blood test carried out in the second trimester of pregnancy, doctors can look for a certain type of protein that indicates spina bifida. With amniocentesis or an ultrasound, this may be confirmed.

After birth, the doctor may be able to make a diagnosis if there is a sac on the baby’s back in the case of myelomeningocele. Other tests to make a diagnosis of spina bifida include:

  • X-rays
  • MRI
  • CT-Scan

Treatment Options for Spina Bifida

Once a diagnosis has been made, the next step for parents is to determine what the best course of action will be in terms of treatment. This will depend on the type of spina bifida, and the degree of severity of symptoms.

  • Surgery – The most effective treatment option at an early age is surgery. If the spinal cord has been exposed, special care must be taken in handling the infant in order to prevent any further damage or infection.
  • Ventricular Peritoneal Shunt – If the infant has hydrocephalus, then a shunt can help drain any extra fluid from the head.
  • Antibiotics – Because children will be more prone to infections, antibiotics may be necessary.
  • Catheters – If urinary incontinence is a symptoms of more severe forms of spina bifida, the patient will need a catheter put in place to help regulate bladder function.
  • Orthopedic Therapy – Braces can help treat joint or muscle problems, leading to increased mobility.

With the right care, it’s possible for children with spina bifida to lead a long and productive life. However, the need for treatment may be ongoing.

References:

1. http://www.nhs.uk/Conditions/Spina-bifida/Pages/Introduction.aspx

2. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002525/#adam_001558.disease.symptoms

3. http://www.webmd.com/parenting/baby/tc/spina-bifida-topic-overview

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