Spina Bifida

1. Introduction

Spina bifida is a birth defect involving the spine, that is, the spine does not form normally during intrauterine development. Spina bifida is a neural tube defect. There are different types of neural tube defects, and different forms of spina bifida. This article will discuss the most serious spina bifida, also called "open spina bifida" or "myelomeningocele." The spine of the child did not form normally, so the lumbosacral skin was defective, and the spinal cord (the nerve bundle running down the back) and its covering tissue bulged out of the defect in a cystic shape. 

There are individual differences in the problems caused by spina bifida, but generally can cause: 

◆ Lack of power or inability to walk 

◆ Loss of lower limbs or paraplegia 

◆ Foot, knee, hip, leg or spine problems 

◆ Incontinence 

◆ Learning, concentration or memory problems 

Most children also have hydrocephalus, that is, excessive cerebrospinal fluid (the fluid that surrounds and protects the brain and spinal cord), which causes the head to enlarge in a short period of time and compress the brain.

2. Examinations

Blood tests can be performed during the fourth month of pregnancy to assess whether the fetus has spina bifida. If the examination shows that the possibility is high, an ultrasound examination is required, that is, the use of sound waves to assess fetal growth and organ development, which can show whether there is spina bifida. Some women do not undergo blood testing and go directly to ultrasound. Physical examination can be used to determine whether there is spina bifida after birth.

3. Treatment Options

Surgery is required shortly after birth to close the back defect. Continue to cover and protect the defect before the operation, and use antibiotics to prevent infection. The condition of hydrocephalus needs to be clarified, and imaging examinations such as ultrasound, CT scan or MRI will be performed. This type of examination can image the baby's brain, and the doctor determines the specific examination items. Medical staff measure the baby's head circumference every few days. 

Children with hydrocephalus are usually treated with a ventricular-abdominal shunt. That is, the shunt tube placed in the brain ventricle subcutaneously distributes the cerebrospinal fluid into the abdominal cavity or the heart, which helps to drain the excess cerebrospinal fluid from the brain. 

Other treatments depend on complications. Treatment is lifelong, and many children will: 

◆ Use a wheelchair or wear a leg brace to help walking 

◆ Using a urinary catheter to help empty the bladder ( if the bladder is not working properly )----helps prevent infection and kidney damage. 

◆ Surgery to repair spine or lower limb problems 

◆ Evaluate whether there is a learning disability: some children with learning disability require a special learning plan.