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SPINA BIFIDA

What is Spina Bifida ?

The spinal cord is a long thick nerve which runs from the brain down the spine and carries nerves to the legs, the bladder and bowels. The spinal cord is very delicate and is surrounded by the bone of the spine, which protects it. In spina bifida this bone and the spinal cord do not develop properly. This can happen anywhere along the spine. The baby is born with a large bump on their back. The baby may have paralysis of the legs and not be able to control their bladder or bowels. Many children with spina bifida also have an obstruction to the flow of fluid in the brain (hydrocephalus). Pressure can build up and the head enlarges.

How does Spina Bifida occur ?

The spinal cord and the spine do not develop properly when they grow at the start of pregnancy. The spinal cord may become infected because it is exposed on the skin. Pressure in the brain caused by hydrocephalus can damage the brain.

Why does Spina Bifida occur ?

The cause is not known. Some families seem to have an increased risk of this happening, so there may be an inherited factor. If a woman takes tablets of folic acid (a vitamin) for a few months before becoming pregnant and during the first 3 months of the pregnancy she can markedly reduce the chances of spina bifida in her baby.

Treatment involved for Spina Bifida

Prevention All pregnant women are screened. This may be with a blood test or with an ultrasound scan. The scan is done at about 16 weeks of pregnancy and looks carefully at the spine, which should be fully formed by that stage. If the fetus has spina bifida the woman will be offered a termination of pregnancy. Treatment of a newborn baby with hydrocephalus. Tests will be done to tell how severely affected the baby is. Spina bifida can vary from a minor problem with walking to being very serious with no hope of survival. Surgery can cover up the spinal cord with skin and prevent infection, but cannot repair the nerves which have not developed normally. Treatment of the hydrocephalus. Most children with spina bifida have hydrocephalus, and this may require an operation to put in a shunt. A shunt is a tube with a valve which allows fluid to drain away from the brain. The valve keeps the pressure in the brain at a normal level. Older children with hydrocephalus. Most older children with spina bifida have problems walking or are in a wheelchair. They may require help from physiotherapists and occupational therapists to keep mobile. Some children need operations to release contracted tendons and muscles. Treatment and operations can sometimes help with controlling the bladder and bowels. Hydrocephalus can cause mental handicap even if a shunt is put in and works well.

During treatment for Spina Bifida

Children may not be able to recognise infections or injuries because of their paralysis. If they cannot control their bladder they are at risk of urine infections. A shunt put in for hydrocephalus may block up or become infected. Parents are taught to recognise the signs of this, which are drowsiness, severe headache or a fever that does not settle down.

If Spina Bifida is left untreated

If a child was not operated on it is likely that they would develop infection and die. If hydrocephalus is not treated with a shunt, the pressure in the brain would increase and cause damage. This would cause severe mental handicap or the child would die.

Effects on the family of Spina Bifida

The birth of a child with spina bifida can be a great blow to a family. As the child grows up they will need a great deal of care and attention from their family. They may need a lot of medical attention and special help with schooling.