National Spina Bifida Month

October is recognized as Spina Bifida awareness month. Spina bifida is a congenital condition where the spinal cord doesn't fully develop, leading to potential neurological and physical challenges. During the month of October events, campaigns, and educational initiatives are held to promote understanding, support, and research for individuals living with spina bifida and their families. The awareness efforts aim to enhance early detection, access to healthcare, and social inclusion for those affected by the condition.

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WHAT IS SPINA BIFIDA?

Spina bifida is a congenital condition that occurs during early fetal development when the neural tube, which eventually develops into the brain and spinal cord, does not close completely. This incomplete closure can lead to malformation or incomplete development of the spine and spinal cord. Infants are born with a section of the spinal cord and spinal nerves exposed through an opening in the back. Spina bifida can vary in severity, and its effect on individuals can range from mild to severe.

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WHAT CAUSES SPINA BIFIDA?

The exact cause of spina bifida is not entirely understood, but it is believed to involve a combination of genetic and environmental factors. Folate (a B-vitamin) deficiency during pregnancy has been identified as a potential risk factor.

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HOW IS SPINA BIFIDA DIAGNOSED?

Spina Bifida is typically diagnosed during pregnancy or shortly after birth. There are different diagnostic methods depending on the stage of detection:

Prenatal Diagnosis: Spina bifida can be detected during routine prenatal screening or through specialized tests. Prenatal screening methods include:

Ultrasound: During a routine ultrasound examination, a doctor may identify characteristic features of spina bifida, such as an open neural tube defect or a fluid-filled sac (meningocele) on the baby's back.
Maternal Serum Alpha-Fetoprotein (MSAFP) Test: This blood test measures the levels of alpha-fetoprotein in the mother's blood. Abnormally high levels may indicate a neural tube defect, including spina bifida.
Amniocentesis or Chorionic Villus Sampling (CVS): In certain cases, if there are higher risks of neural tube defects, the doctor may recommend these invasive tests to analyze the baby's chromosomes and identify any genetic abnormalities.

Postnatal Diagnosis: If spina bifida is not detected prenatally or the condition is not severe enough to be detected on an ultrasound, it may be diagnosed after birth. Doctors can diagnose spina bifida through a physical examination and medical imaging:

Physical Examination: After birth, the baby will undergo a thorough physical examination, during which the doctor will look for signs of an open spinal defect or other physical abnormalities on the back.
X-rays or Magnetic Resonance Imaging (MRI): These imaging techniques can provide detailed images of the spine and help identify the type and extent of the spina bifida.
Neurological Evaluation: A neurological examination may be performed to assess the baby's reflexes, muscle strength, and sensation. This evaluation can help determine the level of spinal cord involvement and potential neurological impairments.

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TYPES OF SPINA BIFIDA

Occulta: This is the mildest form, where the spinal cord and nerves remain undamaged, and the defect is not visible externally. In occulta, there may be a small gap in one or more of the vertebrae.

Meningocele: In this type, the protective covering of the spinal cord (meninges) protrudes through the gap in the vertebrae, forming a sac filled with cerebrospinal fluid. The sac may be visible on the baby’s back, but the spinal cord is usually not involved.

Myelomeningocele: This is the most severe form of spina bifida. In myelomeningocele, the sac containing the meninges and a portion of the spinal cord protrudes through the gap in the vertebrae. This condition can result in damage to the nerves and can lead to various physical and neurological disabilities.

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HOW CAN SPINA BIFIDA AFFECT A CHILD?

Spina bifida can affect a child in various ways, and the extent of impact largely depends on the severity and type of spina bifida. The effects can be mild, moderate, or severe, and they may involve physical, neurological, and cognitive challenges. Here are some common ways spina bifida can affect a child:

Physical Impairments: Spina bifida can cause paralysis or weakness in the lower limbs, leading to difficulty walking or mobility challenges. In more severe cases (myelomeningocele), there may be complete or partial paralysis below the level of the spinal defect.
Bladder and Bowel Issues: Children with spina bifida often have difficulty controlling their bladder and bowel functions. They may require catheterization or other forms of management for urinary incontinence and may experience constipation.
Hydrocephalus: Hydrocephalus is a condition characterized by the buildup of excess cerebrospinal fluid in the brain. Many children with spina bifida also have hydrocephalus, which may require surgical placement of a shunt to drain the fluid and relieve pressure on the brain.
Orthopedic Problems: Children with spina bifida may develop orthopedic issues, such as scoliosis (curvature of the spine), hip dislocation, or foot deformities.
Learning Difficulties: Some children with spina bifida may experience learning difficulties, cognitive impairments, or attention deficits, which can affect academic performance and daily functioning.
Social and Emotional Challenges: Dealing with physical limitations and medical interventions can impact a child's social and emotional well-being. They may face challenges related to self-esteem, body image, and acceptance among peers.
Latex Allergy: Many children who have spina bifida are allergic to latex (natural rubber). If your baby is allergic to latex, keep them away from items made of latex, such as latex bottle nipples, teething toys, changing pads, mattress covers and pacifiers.

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WHO TREATS SPINA BIFIDA?

The treatment of spina bifida involves a multidisciplinary approach, with various healthcare professionals and specialists collaborating to address the different aspects of the condition. The primary healthcare providers involved in treating spina bifida include:

Pediatrician: A pediatrician or family medicine physician is often the first point of contact for parents and children with spina bifida. They provide general medical care, monitor the child's overall health, and coordinate care with other specialists.
Neurosurgeon: Neurosurgeons play a crucial role in the management of spina bifida, especially in cases of myelomeningocele (the most severe form). They perform surgical closure of the spinal defect soon after birth to protect the exposed spinal cord and nerves. Neurosurgeons may also be involved in the treatment of hydrocephalus, which commonly occurs with spina bifida.
Orthopedist: Children with spina bifida may experience orthopedic issues, such as scoliosis, hip dislocation, and foot deformities. Pediatric orthopedic surgeons specialize in managing and correcting these musculoskeletal problems.
Physical Therapist: Physical therapists work with children with spina bifida to improve their mobility, strength, and motor skills. They help the child achieve their maximum physical potential.
Occupational Therapist: Occupational therapists help children with spina bifida develop the skills needed for everyday activities and tasks, such as dressing, feeding, and writing.
Urologist: Urologists specialize in treating urinary system conditions. They play a significant role in managing bladder and urinary issues that are common in children with spina bifida.
Pediatric Neurologist: Neurologists diagnose and treat neurological conditions. They may be involved in assessing and managing any neurological complications associated with spina bifida.

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The treatment and care for each child with spina bifida is individualized based on their specific needs and challenges. The multidisciplinary team works together to develop a comprehensive care plan that addresses all aspects of the child's health and well-being.

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