Spina bifida

Spina bifida is a birth defect that occurs when the spine and the spinal cord of the baby don't form normally. It's a type of neural tube defect. The neural tube is the structure of the developing baby (embryo) that eventually becomes the baby’s brain, spinal cord, and the tissues that enclose them.

In normal conditions, the neural tube forms early in pregnancy and closes by the 28th day after conception. But in babies with this condition, a portion of the neural tube doesn’t develop properly, as a result, the spinal cord and the nerves that branch out of it may be damaged and cause physical and mental issues.

Depending on the severity of the condition and the location on the spine, symptoms vary. If it's mild, it may cause a few or no problems. If the severity is more then it may cause serious problems that include weakness, loss of bladder control, or paralysis.

Children with an exposed opening on the back will need surgery but it doesn't completely resolve the problem.

There are 3 main types of Spina bifida:

Spina bifida occulta (SBO): is the most common and mildest form of the defect. In this, the spinal cord and nerves are fine, but there could be a small gap in the spine which is not known to many people that they have it. This type of spina bifida doesn’t cause any disability.

Spina bifida aperta includes two types of spina bifida:

Meningocele: it is a rare type of spinal bifida, which happens when a sac of spinal fluid pushes through an opening in the baby's back. This sac is noticeable on a baby’s head, neck or back. The sac could be as small as a grape or as big as a grapefruit that is covered by a thin layer of skin. Meningocele can occur anywhere along the spinal column or at the base of the skull. Babies with this condition may have health issues if the nerves around the spine are damaged.

Myelomeningocele: This is the most severe type of spina bifida. It happens when the baby's spinal canal is open in one or several places in the lower or middle back, and a sac of fluid protrudes out which causes damage to the spinal cord and the nerves.

Sometimes, the sac bursts during childbirth, and the spine and nerves are exposed at birth. Babies born with this condition usually have some paralysis.

It is common to have hydrocephalus in babies with this condition. A cerebrospinal fluid forms in and around the brain that causes an enlarged head or bulging soft spot at birth, this is a result of too much fluid and pressure inside the skull.

No one knows the cause of this condition. Doctors think it is because of the environment and family history, or lack of folic acid in the mother's body. Also, a woman who has diabetes or over obese may have a child with spina bifida.

Spina bifida can be diagnosed when the baby is still in the womb by taking certain prenatal tests:

• Blood tests
• Ultrasound
• Amniocentesis
• MRI

The treatment depends on the severity. As this condition involves many different body systems, like nervous and skeletal systems. A team of doctors is required to support the baby that includes neurosurgeons, urologists, and orthopedic surgeons, physical and occupational therapists.

A baby with spina bifida occulta does not need any surgery unless their spinal cord is tethered.

A baby with meningocele requires surgery to push the meninges back into the body and close the hole in the vertebrae or skull. It's done in the first few months after the birth.

Baby with myelomeningocele requires surgery in 1 or 2 days after birth to protect the exposed area and central nervous system, and prevent infections. If the condition is detected during pregnancy, the fetus can be operated on to correct the defect during the 25th week of pregnancy.