SPINA BIFIDA
Spina Bifida is a paediatric spine problem. Mostly during the pregnancy a child's spinal canal and backbone close by the time child is born. In Spina Bifida this does not close and remains as a defect. Spina bifida happens during the first 28 days of pregnancy, often before a woman knows she’s pregnant. This is also called neural tube defect. There can be many types of spina bifida defects, however meningomylocele is the most severe and critical. A child with meningomyelocele is born with the spinal cord exposed. A sac on the baby’s mid to lower back may cover the exposed spinal cord. In such cases spinal cord has not developed properly and the brain is also affected. The most common problem in the brain due to meningomyelocele is hydrocephalus. It has to be noted that not just children but adults may also be affected by spina bifida and may have different severity and symptoms.
SYMPTOMS & DIAGNOSIS
The symptoms in case of simple spina bifida are not that severe however in case of meningomyelocele they are severe. The severity and symptoms depends upon:
The size and location of the neural defect
Whether the skin covers the affected area
Which nerves come out of the spinal cord
Following are the symptoms and complications:
Walking disability due to weakness in muscles and legs which can even lead to even paralysis
There may be certain orthopaedic issues which may be curved spine, hip dislocation, bone deformities etc
There can be bowel and bladder issues as well which may cause loss of bladder and bowel control
Hydrocephalus is one of the most common complications of brain that the patients of spina bifida face
Tethered spinal cord results when the spinal nerves bind to the scar where the defect was closed surgically.
Diagnosis is done best through an ultrasound and certain blood tests in most of the cases that are seen at the spine clinic in New Delhi by our spine specialist Dr Sudeep Jain. Dr Jain is one of the very few spine specialist in New Delhi, India who is trained in treating paediatric as well as adult spine cases.
TREATMENT
Spina bifida treatment depends on the severity of the condition. Myelomeningocele requires surgery. Performing the surgery early can help minimize the risk of infection associated with the exposed nerves. It may also help protect the spinal cord from more trauma. During the procedure, a neurosurgeon places the spinal cord and exposed tissue inside the baby's body and covers them with muscle and skin. At the same time, the neurosurgeon may place a shunt in the baby's brain to control hydrocephalus.
Children who have already developed complications due to spina bifida may need continuous ongoing treatment which may incldue orthopaedic treatment, neurosurgery and physiotherapy.
