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Pediatric Neurosurgery

Spina Bifida

Spina Bifida is a birth condition that affects the spine. We can protect and help your baby.

Spina Bifida

Spina Bifida is a neural tube congenital disability. It happens when the spine and spinal cord do not develop properly. The neural tube is the structure found in an embryo, from which the brain, spinal cord, and the tissues surrounding them created. 

The neural tube usually develops early in pregnancy and closes 28 days after fertilization. Patients with spina bifida, do not correctly generate a part of the neural tube, which causes imperfections in the spinal cord and the bones of the spine. 

Spina bifida can change from mild to severe, depending on the defect it presents (size, location, and complexity). In some cases it is necessary to resort to surgery; however, this does not guarantee that the problem ends. 

 

Types of Spina Bifida: 

There are different types of spina bifida: hidden Spina Bifida (more frequent and milder), Myelomeningocele, or Meningocele.

  1. “Hidden” Spina Bifida: This is the most common and mild form of Spina Bifida, an opening in one or more vertebrae of the spine with no apparent damage to the spinal cord.

  2. Meningocele: Is the moderate form of Spina Bifida. The protective covering around the spinal cord comes out through the vertebrates opening in a sac called a meningocele. The spinal cord is still intact; this can be repaired with little or no damage to the nerve pathways. The sac contains no spinal cord or nerves.

  3. Myelomeningocele: This is the most severe form of Spina Bifida.  A part of the spinal cord itself protrudes through the back. In some cases, the sacs are covered with skin; in others, the tissues and nerves are exposed. Most babies with myelomeningocele also have hydrocephalus, and problems with bowel and bladder function are very common.

Symptoms of Spina Bifida:

The symptoms vary depending on the type of spina bifida present. Hidden spina bifida does not often present symptoms. We group the most common signs that can occur:

  • Marks on the newborn's skin

  • Abnormal lock of hair

  • Small dimple on the skin

  • The membranes covering the medulla protrude to form a sac of fluid

  • The spinal canal is exposed, the membranes and marrow protrude and form a sac, the tissues and nerves are often exposed

  • Bowel or bladder problems

  • Hydrocephalus

  • Loss of sensation or inability to move your lower legs

  • Orthopedic Problems

  • Heart problems

Diagnosis of Spina Bifida:

  • During pregnancy your doctor can perform tests to diagnose whether Spina Bifida is present, through one of these tests:

  • Blood Tests: The blood is tested for neural tube defects by measuring alpha-fetoprotein (AFP). A high AFP level means that the baby might have Spina Bifida.

  • Sonography or Ultrasound: The doctor can obtain images of the fetus to identify the presence of Spina Bifida while in the uterus.

  • Amniocentesis: A procedure in which the doctor inserts a long, thin needle into the mother's abdomen to remove a small sample of amniotic fluid for testing.

Causes of Spina Bifida:

It is difficult to determine the cause of spina bifida. In most cases, doctors cannot determine a specific cause. However, it is thought to be a combination of genetic, environmental, and nutritional risk factors. 


Risk Factors of Spina Bifida:

Some risk factors include:

  • Mother's age: Spina Bifida is more common when the mother is in her teens 

  • Low folic acid 

  • Family history of neural tube defects 

  • Increased body temperature 

  • Consumption of certain medications 

  • Diabetes 

  • Obesity

  • History of spontaneous abortion

  • A poor diet lacking in essential vitamins and minerals

When to go to a Doctor? 

Myelomeningocele spina bifida is usually diagnosed before or after birth. In this case, children should continually go for a review with the Pediatric Neurosurgeon.

In addition, depending on what type of Spina Bifida has been diagnosed and what problems developed from it:

  • A visit to the Urologist should be made if bowel and bladder problems (commonly occurring with children with myelomeningocele Spina Bifida) or urinary tract infections occur.

  • A visit to the Pediatric Dermatologist should be made if skin problems occur. Many children with Spina Bifida have wounds, blisters, sores, or infections on their feet, legs, back, and buttocks.

  • A visit to the Trauma and Orthopedic doctor should be made if there are orthopedic complications such as hip dislocation, muscle contractures, or bone and joint deformities.

Children who present with hidden Spina Bifida do not usually have any complications. However, they should see their Pediatrician on a routine basis.


Prevention: 

The best way to prevent this is through daily habits. You can reduce your baby's risk of a neural tube defect like Spina Bifida by eating a healthy diet that includes foods rich in folic acid before you become pregnant and within the first three months of pregnancy. 

We group the following recommendations. 

  • Folic acid consumption (at least three months before becoming pregnant and during the first three months of gestation) 

  • Avoiding the consumption of toxic substances

  • Recommended foods with folic acid, for example

    • Avocado 

    • Rice 

    • Broccoli 

    • Spinach 

    • Milk 

    • Fruits 

    • Beans, peas 

    • Enriched bread 

    • Egg yolks 

  • Balanced diet 

  • Do not consume drugs

  • Planning your pregnancy, talk to your Gynecologist

Lifelong considerations:

Spina Bifida is a lifelong condition. Making an impact by positively supporting your child if he or she has it to build self-esteem and be as independent as possible will make a difference. 

Treatment is to prevent or minimize the deformities that occur, focusing on maximizing the child's capabilities. 

 

Remember that birth defects can occur in any family. There are several factors that can affect pregnancy both family genes or problems in gestation. If you are planning to become pregnant or are pregnant, remember that taking folic acid before pregnancy and during the first three months of pregnancy significantly reduces the risk of Spina Bifida.


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