Worldwide, spina bifida is one of the most common of all birth defects, affecting nearly 1 in 1000 newborns. Most cases are asymptomatic, but cosmetic deficiencies involving the skin on the back are fairly common, and severe manifestations of the disease can dramatically impact a patient’s quality of life.
Pregnant mothers can choose a premier pediatric neurosurgeon at NSPC to treat spina bifida before the baby’s birth. With extensive experience in all forms of pediatric neurosurgery at some of the most prestigious medical centers throughout the country, our surgeons offer you and your child excellent care and expert treatment options.
What is Spina Bifida?
Spina bifida is a congenital defect (meaning present at birth) where the spinal column has not fully formed around the spinal cord during fetal development.
Types of Spina Bifida
Spina bifida is generally categorized into three types:
Spina bifida occulta – The more common and mild form of spina bifida, it is often asymptomatic (occulto is Latin for hidden or covered), and many times is only discovered when the patient has an x-ray of their back performed for another condition. Although there is a small abnormal opening in the spine, no opening or fluid-filled sac is present. Meningocele – A sac of fluid collects under the skin as the meninges (the membrane that encloses the spinal cord) pushes out through unsealed openings in the vertebrae. Myelomeningocele – This is the rarest and most severe form of the condition, with the worst array of spina bifida symptoms associated with it. This is the condition most people commonly associate with the name. The fluid-filled sac not only contains some of the meninges but also nerves or spinal tissue.
Causes and Symptoms of Spina Bifida
Although it is one of the most common birth defects, the causes of spina bifida remain elusive to the medical community. Thus many urban myths about the causes of spina bifida abound.
Individual factors such as a mother’s folic acid intake have been correlated with incidence rates, but there is likely a wide variety of factors that are not yet fully understood.
Possible Factors Correlated with Spina Bifida Causes
Genetic – Research in mice indicates a genetic component to at least some forms of the disease. Since the condition does not follow normal hereditary patterns, genetics are not the only class of potential causes.
Nutritional – Folic acid supplements taken during the first month of pregnancy have been proven to reduce the incidence of the condition by upwards of 70%—even more in families which have a history of the condition.
Environmental – Finally, environmental issues may contribute to spina bifida incidents. Patients who suffer from aggravating conditions such as obesity or diabetes are significantly more likely to have their children develop the condition.
Symptoms can vary according to the type of spina bifida.
Spina Bifida Occulta Symptoms – Many patients with spina bifida occulta may not show any symptoms nor need any treatment. These symptoms may or may not be present:
dimpling of the flesh, odd tufts of hair on their back, birthmarks or other cosmetic issues
bowel or bladder issues
scoliosis (sideways curve of the spine)
Meningocele Symptoms – The symptoms associated with this condition almost always manifest along with a bulge of fluid collecting under the skin as the meninges (spinal membrane) pushes out through the spinal column:
bowel or bladder issues
weakness in the legs
Myelomeningocele Symptoms – Nerves or spinal tissue protrudes from the back, and nerve damage can affect extremities:
difficulty moving parts of the body
muscle weakness in feet, hips, and legs that result in deformities
suffer from incontinence
have difficulty walking
Other conditions associated with spina bifida include hydrocephalus, myelopathy (disease of the spinal cord), syringomyelia, Chiari malformations, tethered spinal cord (spinal cord malformation when the cord attaches itself to the spinal column), latex allergies and paralysis. Some patients may have learning difficulties.
World-Class Treatments for Spina Bifida Offered by NSPC in New York State
The Three Stages of Spina Bifida Treatment
Prenatal – In some cases, spina bifida treatment can actually be performed in-utero. During the fetal surgery, an incision in the uterine lining allows the pediatric neurosurgeon to repair the spinal cord opening. Intrauterine surgery to repair the spinal cord’s abnormal opening, may limit the development of hydrocephalus or Chiari malformations.
Initial – In most cases, when you deliver a child with the condition, they will require initial surgical treatment. In some cases, the less severe meningocele may also require surgical treatment, though this is somewhat rare. With meningocele, the spinal cord itself is mostly unaffected, so surgery can remove the membranes causing this fluid collection with little risk to the nerve pathways themselves. Depending on the health of the child, this initial surgical correction can take place anywhere within the first six weeks post-birth. Hydrocephalus must also be aggressively guarded against.
Ongoing – Physical and occupational therapy will likely be needed throughout the individual’s life. Most ongoing spina bifida treatment revolves around addressing symptoms and preventing further complications. Nerve damage can lead to clubfoot or hip issues, braces may be required to walk; scoliosis may set in; bladder, kidney, or general incontinence may develop; and a variety of other complications can arise. Spina bifida back surgery may correct severe scoliosis of the back related to this condition. Orthopedic surgery can help those with leg and foot problems.
Your neurosurgeon can work with you to develop a customized treatment plan based on you or your child’s personal symptoms and progression.
If you are pregnant or have recently delivered and are in need of a spina bifida diagnosis or confirmation, contact NSPC and speak with our team of Spinal Specialists on Long Island today.
At NSPC in NY, our team of world-class Neurosurgeons and Spinal Specialists will explain spina bifida to you in detail, and then discuss either screening or treatment plans depending on your needs.