Spina Bifida: During early development, the spinal column begins as a flat plane. In the first month of pregnancy it begins to curl and eventually seals into a tube shape. When a child has spina bifida, this means the tube did not completely seal. There are three types of spina bifida:
- Occulta: This is the mildest form and involves an opening into the vertebrae without a protrusion of the spinal cord or meninges. Many people do not know they have this. There may be a large mold or patch of hair or a deep dimple on the skin along the spine.
- Meningocele: The spinal cord will have developed normally, but when the child is born there is a sac protruding from a hole in the vertebrae and out of the back. It is important to have surgery early as the sac may break and infection and nerve damage may occur. Often this form of spina bifida does not present any problems once the back is closed.
- Myelomeningocele (Meningomyelocele): This is the most common and the most serious form of spina bifida. The protruding sac on the back will contain tissue, spinal fluid, nerves and part of the spinal cord. The spinal cord may be damaged or not properly formed. There is always some degree of paralysis and loss of sensation below the damaged vertebrae. Children may need a walker or wheel chair depending on the level of paralysis.
Causes: The exact causes of spina bifida are unknown. However, genetics may play a role as well as high fevers and certain medications. A lack of folic acid during pregnancy may also lead to neural tube defects.
Possible complications: Children with myelomeningocele often have hydrocephalus and/or clubbed feet. Some children with spina bifida have problems such as curvatures in the back, hip dislocation, ankle and foot deformities and contracted muscles. Depending on the severity of the spina bifida, children are also at greater risk for paralysis and infection.
Treatment: Children with meningocele and myelomeningocele need surgery to put the meninges (nerves) back into the spinal column and close the opening in the spine.
Prognosis: The long-term prognosis for children with spina bifida depends on the severity and treatment. Surgery should be done as early as possible to have the best possible results. However, children in certain countries may not be able to have early intervention. The longer a child goes without surgery, the greater the risk for serious, long-term complications such as infection and paralysis.
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