Spinal Bifida

Subject: Midwifery III (Theory)

Overview

Spina bifida occurs when the spinal vertebrae don't grow in correctly around the spinal cord. Spina Bifida is categorized into three broad groups based on the degree of abnormality and severity of outward presentation. Some genetic predisposition and environmental factors are suspected as contributing factors. The tiniest form of spina bifida occurs when one or more spinal bones (vertebrae) become slightly dislocated from one another. The most severe form causes spinal stenosis, which is a leading cause of death among people with spinal cord injuries.

Hydrocephalus is a common cause of brain injury of varying severity. Myelomeningocele, or open spinal Bifida, is a birth defect in which the spinal canal of the newborn is exposed along many lumbar or middle back vertebrae. When a newborn is born, a sac forms where the membranes and spinal cord have broken through.

Neural tube defects, including Spina Bifida, are quite common in newborns. It occurs when the spinal vertebrae don't grow in correctly around the spinal cord in a developing newborn.

Causes:

Exactly what causes this congenital disorder is a mystery. Some genetic predisposition and environmental factors are suspected as contributing factors, according to experts. Women who have once given birth to a child with spina bifida have a higher risk of having another child born with the condition. Spina bifida is also more common in children born to fat or diabetic mothers.

Types:

Spina bifida is categorized into three broad groups based on the degree of the abnormality and the severity of the outward presentation.

hidden spina bifida (pronounced o-cult-tuh;)

As the most common type, this condition is often never found because it is hard or impossible to see on an ultrasound because it is so small. One or more vertebrae are not fully closed, causing this kind of spina bifida. In most cases, just one vertebrae is impacted. More than one damaged vertebra will likely fuse improperly with the others, leading to back stiffness. Since no part of the spinal cord or nerves protrude through the gap, this type of spina bifida often does not cause any noticeable physical impairments.

Meningocele and spina bifida (pronounced ma-nin-jo-seal;)

That particular sort of neural tube defect is quite uncommon. The protective covering of the spinal cord pushes through the cleft or opening in the vertebrae, defining this subtype. The cyst-like formation on the child's back is caused when the membrane and/or spinal fluid protrudes. Even if some spinal cord injury persists after the cyst has been removed, surgical intervention is possible. This kind of spina bifida is characterized by relatively mild physical impairments, such as incontinence.

myelomeningocele spina bifida (pronounced my-low-ma-nin-jo-seal;)

The severity of this variant of the abnormality at birth is unparalleled. The membrane and the spinal cord both protrude through the breach in the vertebrae. Because of the severe damage and permanent impairments it causes, spinal stenosis is a leading cause of death among people with spinal cord injuries. Furthermore, the hindbrain is frequently dragged lower into the spinal canal, resulting in significant compression of the cord and, in extreme cases, brain injury, because the spinal cord is not a single chord running through the spinal canal. When the back of the brain presses on the spinal canal, it can restrict cerebrospinal fluid flow and lead to hydrocephalus. Hydrocephalus is a common cause of brain injury of varying severity. A kid with this kind of spinal bifida would likely have significant physical and neurological impairments, including learning challenges.

Clinical signs:

There are varying degrees of severity among the three types of spinal bifida:

Occult spina bifida

The tiniest form of this disorder occurs when one or more spinal bones (vertebrae) become slightly dislocated from one another. Most children with this kind of spina bifida have no symptoms and no neurological issues since the spinal nerves are not affected.

Sometimes, signs of spina bifida occulta, such as those listed below, can be observed on the skin of a baby above the spinal deformity:

An abnormally large clump of hair
A collection of fat
Mark on the skin, such as a dimple,
Many persons with spina bifida occulta do not realize they have it until the problem is uncovered by chance during a routine X-ray or other imaging exams.

Meningocele

In this extremely unusual presentation, the meninges, which normally surround and protect the spinal cord, protrude through the space between the vertebrae. Due to typical spinal cord development, surgical removal of these membranes poses minimal risk to nerve fibers.

Myelomeningocele

Myelomeningocele, or open spinal Bifida, is the most severe variant and is what most people refer to when they talk of spinal Bifida.

Myelomeningocele is a birth defect in which the spinal canal of the newborn is exposed along many lumbar or middle back vertebrae. When a newborn is born, a sac forms on the back where the membranes and spinal cord have broken through.

The sac may be covered by skin in some situations. But the exposed tissues and nerves often leave the infant vulnerable to potentially fatal infections.

A variety of neurological problems are rather frequent.

Leg muscle weakness that can progress to paralysis
Digestive and voiding disorders
Constant or recurrent seizures, especially if the child needs a shunt
Orthopedic problems — such as deformed feet, uneven hips, and a curved spine (scoliosis).

Things to remember

Birth defects like spina bifida, which affect the nervous system, are classified as neural tube defects.
It happens when the spinal vertebrae fail to develop normally, trapping a portion of the developing spinal cord between them.
Exactly what causes this congenital disorder is a mystery. Both genetic predisposition and environmental factors are likely at play, according to the experts.
Women who have once given birth to a child with spina bifida have a higher risk of having another child born with the condition.
Spina bifida is also more common in children born to fat or diabetic mothers.
Spina bifida is categorized into three broad groups based on the degree of the abnormality and the severity of the outward presentation.
Spina bifida can take several forms, including spina bifida occulta, spina bifida meningocele, and spina bifida myelomeningocele.
There are varied degrees of severity among the three types of spinal bifida.

Questions and Answers

Define spinal bifida .

A birth abnormality referred to as a neural tube defect is spina bifida. It happens when the vertebrae of the spine don't properly develop around a portion of the baby's spinal cord.

What are the types of spinal bifida?

Based on the severity of the abnormality and its outward expression, spinal Bifida can be divided into three general categories.

Occult Spina Bifida (Pronounced o-cult-tuh)

Since it is the most prevalent kind, this sickness frequently goes undetected because it is quite challenging to spot such a small illness on ultrasound. Spina bifida in this kind develops when one or a few vertebrae are not entirely closed. Frequently, only one vertebra is impacted. These vertebrae typically fuse improperly with one another if more than one are afflicted, resulting in back stiffness. This type of spina bifida rarely results in a physical handicap since nothing protrudes from the spinal fissure.

Eningocele with Spina Bifida (Pronounced ma-nin-jo-seal)

This neural tube abnormality manifests itself in its rarest form. This type is distinguished by a protrusion of the spinal cord's protective sheath through the vertebral fissure or hole. Only the membrane may protrude occasionally; more frequently, however, the spinal fluid fills the protrusion, creating a cyst-like mass on the child's back. Surgery can treat and remove this cyst, although the spinal cord may still sustain some harm. This type of spina bifida is frequently accompanied by minor physical impairments, such as incontinence problems.

Myelomeningocele with Spina Bifida (Pronounced my-low-ma-nin-jo-seal)

This kind of birth defect is the most severe kind. In addition to the membrane sticking out of the vertebral fissure, the spinal cord also does so. This spinal cord bowing results in severe physical impairments that last a lifetime. Additionally, the hindbrain is frequently forced downhill into the canal because the spinal cord does not pass through the spinal canal in a straight line, resulting in severe cord compression and, occasionally, brain damage. A hazardous disease known as hydrocephalus can arise from a blockage of spinal fluid flow caused by the hindbrain in the spinal canal. Various degrees of brain injury are frequently brought on by hydrocephalus. Typically, a kid with this type of spinal Bifida would experience paralysis or other severe physical challenges in addition to learning impairments.