A congenital spinal defect in which part of one or more vertebrae fails to develop completely, leaving a portion of the spinal cord exposed. Spina Bifida can occur anywhere on the spine but is most commonly found in the lower back. The severity of the condition depends on how much nerve tissue is exposed.
Causes and Incidence
The cause of Spina Bifida remains unknown <personal note: Despite the constant regurgitating of the same ideas over and over>, although vitamin deficiency seems to be one of the main factors involved.
In the UK, the number of babies being born with the disorder has been declining recently <Note: read the last 10-15 years>as screening and prevention programmes have come into general use, but the incidence is still about 30 per 100,000 born.
<Note: In plain English. Screening has given parents the option to abort. I was eight years old, watching a programme on TV when my mother came in and found me. I turned to her and said;
"I know I can't do as much as other children, but what I can do I enjoy"
From an eight year old. "what I can do I enjoy". The basis for my objection to abortion on the basis of disability. But this page isn't about that :) >
There are four known distinct forms of Spina Bifida.
Spina Bifida Occulta : The most common and least serious form. Little external evidence apart from a dimple or tuft of hair over the area of the underlying abnormality. Spina Bifida Occulta often goes completely unnoticed in otherwise healthy children, although there are occasionally accompanying abnormalities of the lower part of the spinal cord.
Symptoms of leg weakness, incontinence cold and blue feet may be present from birth or develop later in life.
Meningocele. This form is less severe than myelocele of which more in the next section.
Myelocele. Also know as Myelo-meningocele <Personal note: Me sports fans :)> This is the most serious form of Spina Bifida <I never do anything by halves>
A child with a meningocele is usually severely disabled. The legs are partly or completely paralysed <Yup yup>, with loss of sensation in all areas below the level of the defect <Not true. Motor function yes, sensation no. Sensation and motor functions are lost at different levels. At least mine are>
<NOTE: to those who know me. I do notmean that my motor orcognitive functions are dead from the neck up OK? :)>
;hip dislocation and other leg deformities are common. Hydrocephalus<Yes I wondered when that little beauty would crop up> is a common bedfellow of this condition, excess cerebrospinal fluid <CSF> within the skull, is common and without treatment can result in brain damage <Note: Good excuse for typos too!>
Symptoms. Personal observation. It's usually pretty darned obvious when a child has Spina Bifida Myelocele. The hole in the back exposing the spinal cord at birth is usually a pretty good clue. Other clues are generally overkill, but this is personal opinion.
Encephalocele. This is a rare disorder, related to Spina Bifida where brain tissue protrudes through the skull. Brain damage is usually severe. Another form is where the brain fails to develop, beyond a small nodule on the spinal cord operating the autonomic functions only.
Diagnosis. By ultrasound and or blood tests during pregnancy. High levels of alpha-fetoprotein in the amniotic fluid or maternal bloodstream may indicate Spina Bifida.
As previously noted, after birth Spina Bifida is pretty easy to spot. At least in the more severe forms that are actually disabling to the infant.
Treatment. Closure of the defect to prevent further damage to the nerves and spinal cord. Depending on the severity the child will probably survive, but may have a degree of disability. If Hydrocephalus develops, a shunt <tube and valve mechanism> is inserted into the skull to relieve pressure on the brain. <Note: In infancy the fluid is drained to the stomach, later in life it is diverted to the carotid artery and disperses into the bloodstream>
Mobility and independance are encouraged by physiotherapy. Depending on severity, walking aids and/or a wheelchair may be needed. Special schooling may be required in cases where there is a degree of mental disability.
This has been a personalised look at Spina Bifida based on an entry in a medical encyclopaedia. For a specific look at an offical site, which is still pitched at an acceptable level, please visit the ASBAH Spina Bifidapage.
A Personal look at Hydrocephalus
International Federation for Hydrocephalus and Spina Bifida
Association of Spina Bifida and Hydrocephalus (UK)