Spina Bifida

Author: 
Adoptive Families Association of BC
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Definition
Spina bifida is a condition where some of the vertebrae of the spinal cord are not completely formed and usually the spinal cord and its coverings protrude through the opening. In general, the three types of spina bifida (from mild to severe) are:

  • Spina Bifida Occulta: There is a happening in one more of the vertebrae (bones) of the spinal column without apparent damage to the spinal cord.
  • Meningocele: The meninges (or protective covering around the spinal cord) has pushed out through the opening in the vertebrae in a sac called the "meningocele"; however, the spinal cord remains intact. This form can be repaired with little or no damage to the nerve pathways.
  • Myelomeningocele: This is the most severe form of spina bifida in which a portion of the spinal cord itself protrudes through the back. The bones of the spine do not completely form, and the spinal canal is incomplete. In some cases, sacs are covered with skin; in others, tissue and nerves are exposed.

Causes
Approximately one in every 750 babies born in Canada is born with Spina Bifida.

The cause of myelomeningocele is unknown; however, folic acid deficiency may be one cause. (Folic acid is a common water-soluble B vitamin, essential for the functioning of the human body.) The folic acid deficiency results in anemia (low number of red blood cells circulating in the body) that is thought to play a part in neural tube defects such as myelomeningocele.

If a child is born with myelomeningocele, subsequent children in that family have a higher risk than the general population.

Characteristics
Although the spinal opening is surgically repaired shortly after birth, the nerve damage is permanent. The results include:

  • Partial or complete paralysis of the legs, with partial or complete lack of sensation
  • Loss of bladder or bowel control
  • Increased susceptibility to infection due to the exposed spinal cord(meningitis).

Treatment
The goals of initial treatment are to reduce the amount of neurologic damage caused by the defect, to minimize infection, and to aid the family in coping with the disorder. Follow-up neurologic testing as the child gets older helps to guide rehabilitation.

Treatments include surgery, medication, physiotherapy, and the use of assistive devices. Many people with spina bifida will need support to walk, such as braces, splints, or crutches. Many will need wheelchairs, and almost all will have some form of bladder and bowel dysfunction.

Complications
A large percentage of children born with myelomeningocele have hydrocephalus (an abnormal accumulation of cerebrospinal fluid within cavities called ventricles inside the brain). Hydrocephalus is controlled by a surgical procedure called " shunting" which relieves the fluid buildup in the brain. If a drain (shunt) is not implanted, the pressure buildup can cause brain damage, seizures, or blindness. Hydrocephalus may occur without spina bifida but the two conditions often occur together.

Complications are:

  • Permanent disability with weakness or paralysis of legs
  • Loss of bowel or bladder control
  • Frequent urinary tract infections
  • Meningitis
  • Latex allergy
  • Depression
  • Obesity
  • Skin breakdown

In some cases, children with spina bifida who also have a history of hydrocephalus experience learning problems. They may have difficulty with paying attention, expressing or understanding language, and grasping reading and math. Successful integration of a child with spina bifida into school sometimes requires changes in school equipment or the curriculum. In adapting the school setting for the child with spina bifida, architectural factors should be considered (elevators for instance).


This resource is by no means intended as a substitute for a doctor's advice or diagnosis. Any concerns you may have with regard to your child's health and development should be discussed with a professional in an appropriate field.