Now Know All about Spina Bifida: Cause, Symptoms, Diagnosis, Treatment

Spina bifida is a congenital birth defect where the spinal cord fails to develop or close properly during the early stages of pregnancy. It is a type of neural tube defect (NTD), and its severity can range from mild to severe. The spinal cord and nerves are often affected, potentially leading to physical and neurological disabilities. This condition affects approximately 1,500 to 2,000 babies born each year in the United States. Early diagnosis and proper medical intervention can help manage the condition, although there is no cure. (Source)

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What is Spina Bifida?

Spina bifida occurs when the neural tube, the precursor to the brain and spinal cord, does not close completely during the first month of embryonic development. Depending on the severity, spina bifida is classified into three main types:

1. Spina Bifida Occulta: The mildest and most common form, where the spinal cord and nerves are not visibly affected, but there may be a small gap in the spine. Most people with this form may not even realize they have it.
2. Meningocele: A more severe form in which a fluid-filled sac forms outside the spinal canal, though the spinal cord remains intact. This condition can be treated surgically.
3. Myelomeningocele: The most severe form, where both the spinal cord and nerves protrude through an opening in the spine. This can lead to severe disabilities such as paralysis and loss of bowel or bladder control. (Source)

How is Spina Bifida Caused?

Spina bifida arises due to the failure of the neural tube to close completely during fetal development. The exact cause is not fully understood, but a combination of genetic, environmental, and nutritional factors is believed to contribute. One of the most significant factors is folate (vitamin B9) deficiency during pregnancy. Folate is crucial for neural tube development, and insufficient levels can increase the risk of spina bifida and other neural tube defects.

History and Science of Spina Bifida

The term “spina bifida” comes from Latin, meaning “split spine,” and it has been recognized for centuries. Descriptions of the condition can be found in ancient medical texts, but significant advancements in its understanding began in the 20th century.

The discovery of folic acid’s role in preventing neural tube defects came in the 1990s, leading to the recommendation that women of childbearing age should take folic acid supplements. Research also identified the importance of early surgical intervention to repair the spine in babies with severe spina bifida, particularly myelomeningocele.

In recent years, fetal surgery (performed before the baby is born) has been developed as a treatment for severe spina bifida. This has improved outcomes for many babies born with the condition, reducing the need for more invasive surgeries after birth. (Source)

Risk Factors for Spina Bifida

Several factors may increase the likelihood of a baby being born with it, including:

1. Folate Deficiency: Insufficient folic acid intake before and during early pregnancy is one of the most significant risk factors.
2. Family History: A family history of neural tube defects increases the risk of having a baby with it.
3. Maternal Diabetes: Women with poorly controlled diabetes during pregnancy are at a higher risk of having a baby with it.
4. Obesity: Obese women have a higher likelihood of having a child with neural tube defects.
5. Medications: Certain anti-seizure medications, such as valproic acid, have been linked to a higher risk of neural tube defects.
6. Environmental Factors: Exposure to high temperatures, such as through fever or hot tubs, during the early stages of pregnancy has also been associated with an increased risk of it. (Source)

Treatment for Spina Bifida

The treatment of it depends on the type and severity of the condition. While it cannot be cured, various treatments and interventions can improve the quality of life for those affected.

1. Prenatal Surgery: For severe forms of spina bifida, fetal surgery may be performed between 19 and 26 weeks of pregnancy. The surgeon repairs the opening in the spine while the baby is still in the womb, which has shown to improve motor function and reduce complications.
2. Postnatal Surgery: For babies diagnosed after birth, surgery to close the opening in the spine is typically performed within the first 48 hours of life. This helps prevent infections and additional nerve damage.
3. Physical Therapy and Mobility Devices: Physical therapy is crucial in helping children with spina bifida improve their mobility. In more severe cases, mobility aids such as braces, walkers, or wheelchairs may be necessary.
4. Bowel and Bladder Management: Since it often affects the nerves controlling the bladder and bowels, special training or medical interventions may be needed to manage these functions.
5. Ongoing Medical Care: Individuals with it may need ongoing care from a team of specialists, including neurologists, orthopedic surgeons, and urologists, depending on the severity of their condition. (Source)

Can Spina Bifida Be Prevented?

Although it cannot be entirely prevented, the risk can be significantly reduced by taking the following steps:

• Folic Acid Supplementation: It is recommended that women of childbearing age take 400 micrograms of folic acid daily before conception and during the first trimester of pregnancy to reduce the risk of neural tube defects by up to 70%.
• Healthy Lifestyle Choices: Maintaining a healthy weight, controlling diabetes, and avoiding harmful substances like alcohol and tobacco can also lower the risk of spina bifida.
• Medication Review: Women taking certain medications, particularly those for epilepsy, should consult their doctors before becoming pregnant to ensure that their medications are safe. (Source)

Is Spina Bifida Hereditary?

While it can sometimes occur in families with a history of neural tube defects, most cases are not inherited. The condition results from a combination of genetic and environmental factors, and having one child with spina bifida slightly increases the risk of having another child with the condition. Genetic counseling may be helpful for families with a history of spina bifida to understand their risks.

Can Spina Bifida Be Cured?

There is no cure for this, but early intervention and appropriate medical care can improve outcomes for many children. Treatments like surgery, physical therapy, and mobility aids can help manage symptoms and enable individuals to lead relatively normal lives. The severity of the condition largely determines the long-term outlook. With proper care, many individuals with spina bifida can achieve independence and lead fulfilling lives.

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Conclusion

It is a serious birth defect caused by incomplete closure of the neural tube during early pregnancy. While the exact cause remains unknown, factors like folate deficiency, genetic predisposition, and environmental exposures increase the risk. Advances in prenatal surgery and early intervention have improved outcomes for those affected by it, though lifelong care is often required. Preventative measures, such as folic acid supplementation and maintaining a healthy lifestyle, can significantly reduce the risk of this condition.