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| Spina Bifida (SB) |
Spina Bifida (SB)
Definition:
Spina bifida (SB) is a neural tube defect (a disorder involving incomplete development of the brain, spinal cord, and/or their
protective coverings) caused by the failure of the fetus's spine to close properly during the first month of pregnancy. Infants
born with SB sometimes have an open lesion on their spine where significant damage to the nerves and spinal cord has occurred.
Although the spinal opening can be surgically repaired shortly after birth, the nerve damage is permanent, resulting in varying
degrees of paralysis of the lower limbs. Even when there is no lesion present there may be improperly formed or missing vertebrae
and accompanying nerve damage. In addition to physical and mobility difficulties, most individuals have some form of learning
disability. The three most common types of SB are: myelomeningocele, the severest form, in which the spinal cord and its protective
covering (the meninges) protrude from an opening in the spine; meningocele in which the spinal cord develops normally but the
meninges protrude from a spinal opening; and occulta, the mildest form, in which one or more vertebrae are malformed and covered
by a layer of skin. SB may also cause bowel and bladder complications, and many children with SB have hydrocephalus (excessive
accumulation of cerebrospinal fluid in the brain).
Treatment:
There is no cure for SB because the nerve tissue cannot be replaced or repaired. Treatment for the variety of effects of SB may
include surgery, medication, and physiotherapy. Many individuals with SB will need assisted devices such as braces, crutches,
or wheelchairs. Ongoing therapy, medical care, and/or surgical treatments may be necessary to prevent and manage complications
throughout the individual's life. Surgery to close the newborn's spinal opening is generally performed within 24 hours after
birth to minimize the risk of infection and to preserve existing function in the spinal cord.
Prognosis:
The prognosis for individuals with SB depends on the number and severity of abnormalities. Prognosis is poorest for those with
complete paralysis, hydrocephalus, and other congenital defects. With proper care, most children with SB live well into adulthood.
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