Spina Bifida – Symptoms, Causes, Treatment, Life Expectancy

The congenital defect characterized by the incomplete development of the spine is called Spina Bifida.  The term is Latin which means ‘split’ or ‘cleft spine’. This problem occurs in the early stage of pregnancy when the nervous system of the fetus is still developing. The defect arises when the 2 sides of the fetus’ spine remain open or do not connect with each other, hence, leaving the spinal cord exposed.  The spinal cold may develop abnormally and be subjected to more injury. For this reason, the nerve signals to several parts of the body are affected which leads to abnormal functioning of various organs, muscles and body parts. 

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Spina bifida is one on the most commonly occurring types of neural tube defect. In the US, for instance, the condition is estimated to affect up to 2000 out of four million births annually. It is usually diagnosed before birth and addressed promptly. However, this congenital aberration cannot be cured but the resultant symptoms can be managed and treated.  

What are the causes? 

The root cause for the incomplete development of the spine is still unclear. Nevertheless, several contributing factors are suspected, including heredity, environment and nutrition. The role of folic acid is believed to be important in the proper formation of the neural tube. A woman who does not take in enough folic acid before and during pregnancy is at higher risk of giving birth to a child with neural tube defects such as spina bifida. This is the reason why women who are expecting are prescribed with folic acid supplements.  

Types

Spina Bifida can take on several forms, namely spina bifida manifesta, spina bifida occulta and close neural tube defects.

  •  Spina bifida manifesta

This is the more severe form of the problem which can be further classified into Meningocele and Myelomeningocele. From the name alone, we could deduce that Meningocele is a problem with the membrane that covers the spinal cord and brain called the meninges. Meningocele pertains to the sac that results when the meninges pass through the gap in spine.

Meanwhile, Myelomeningocele arises when both the meninges and the spinal cord pushes through the hole in the vertebrae. Children born with this condition suffer from paralysis, the severity and extent of which depend on where the opening in the vertebrae is located.

  •  Spina bifida occulta

This condition is so called because the defect is hidden and covered by skin. It is the least severe type of spina bifida since most of those affected do not exhibit major health problems and the spinal cord is typically unharmed. Affecting between 10% and 20% of the population, this is the most common form of spina bifida.

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  • Close neural tube defects

These refer to forms of spinal defects characterized by the malformation of membrane, bone or fat in the spinal cord.  The symptoms range from nonexistent to severe malfunctioning of the urinary and bowel, as well as partial paralysis. 

What are the signs and symptoms? 

Depending on the form of spina bifida, the symptoms vary from one case to another. Those with occulta will not have noticeable physical marks, except for some cases where a birthmark, dimple or hair patch is visible on the lower back over the spine. On the other hand, babies born with meningocele or myelomeningocele have fluid-filled sacs that protrude at the back which may or may not be covered by a thin skin layer. The size of the sac ranges from small to very big. The spinal cord nerves may also be exposed. 

Some of the symptoms of include the following:

  • numbness in the lower part of the body
  • partial paralysis of the legs and lower body
  • urinary and fecal incontinence
  • problems in penile erection and ejaculation
  • learning disabilities
  • spinal deformities
  • hydrocephalus 

Treatment

The treatment largely depends on the type of spina bifida as well as the severity of symptoms. Generally, babies affected by occulta do not require treatment. Those with meningocele need to have surgery to put the meninges in its proper place and seal the gap in the spinal column. Infants diagnosed with myelomeningocele must also have immediate operation to place the spinal cord back into the vertebrae, close the gap and protect it from infection. 

In addition, the following may be needed to treat spina bifida:

  • shunt insertion (for hydrocephalus)
  • use of mobility aids
  • bladder surgery
  • orthopedic surgery
  • constant monitoring of the spine, bladder and kidney functioning.

What is the prognosis and life expectancy of individuals with spina bifida? 

In the past, the prognosis for spina bifida cases was not good. But the advances in treatment methods had improved the outlook of children with this condition. It is estimated that about ninety percent reach adulthood, with a number even reaching 60s. However, further studies still need to be conducted to solidify these figures.

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