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Spina Bifida

Spina bifida belongs to the category of birth defects called spinal cord defects.

What it is

Spina bifida is condition characterized by the failure of the developing fetus’ spine to close properly during the first month of gestation. It is a type of neural tube defect, which is an umbrella term for disorders that involve incomplete development of the brain, spinal cord and/or the surrounding tissues that enclose them. In a healthy baby, the neural tube (which is the embryotic structure that eventually becomes the baby’s brain and spinal cord) forms within weeks of conception, and closes shut by the end of the first month of pregnancy. In a baby with spina bifida, the neural tube fails to close completely, often causing damage to the spinal cord, nerves, vertebra and even the brain.

There are three different types of spina bifida, ranging dramatically in severity and prognosis. Spina bifida occulta is the mildest form and occurs when there is a minor separation in at least one of the spinal bones (vertebrae). Neurological problems rarely result from this type of defect, since the nerves are usually unaffected. In fact, this form of spina bifida rarely has any signs or symptoms at all, and many people who are affected are unaware of their condition.

Myelomeingocele is the most common and most severe form of spina bifida. Also called open spina bifida, this defect involves a large opening along the baby’s spinal canal, with the spinal cord and spinal membranes sticking out at birth. This protrusion takes the form of a sac on the baby’s back, and often exposes spinal tissue and nerves. Neurological impairment triggered by nerve damage may cause mobility difficulties such as muscular weakness or paralysis, as well as learning disabilities.

Meningoceles is a rare form of spina bifida in which the tissue covering the spinal cord protrudes from the spinal opening, but the spinal cord itself remains unimpaired.

Symptoms

Spina bifida occulta

At the site of the spinal defect:

  • A patch of hair
  • An excess of fat
  • Skin discoloration
  • A dimple or birthmark

Melomeningocele (open spinal bifida)

  • A protruding spinal cord on the baby’s back, forming a sac of exposed nerves and tissues
  • Partial or complete paralysis
  • Partial or complete lack of sensation
  • Muscle weakness
  • Fluid build-up inside the skull (hydrocephalus)
  • Loss of bladder or bowel control
  • Seizures
  • Scoliosis (curved spine)
  • Deformed feet, such as clubfoot
  • Uneven hips

Causes

Depakote: Babies whose mothers took Depakote (valproic acid) may be at a 12x-16x increased risk of being born with spina bifida, according to a major medical study.

Anti-depressants: Maternal use of certain anti-depressant drugs is associated with a 2-4 fold increased risk of delivering a baby with neural tube defects, according to recently published research. Anti-depressants that may increase the likelihood of spina bifida and other birth defects include:

Painkillers: A major study conducted by the Centers for Disease Control and Prevention (CDC) found that maternal use of opioid painkillers during pregnancy may double the risk of delivering a baby with spina bifida. Opioid painkillers include:

Clomid: According to recent research, children who were born with spina bifida were more likely to have been born to women who took the fertility drug Clomid (clomiphene citrate) between 60 and 15 days before conception. This suggests a connection between maternal use of the drug and the birth defect spina bifida.

Treatment

Surgery may be preformed immediately after birth to close the spinal opening, but serious spina bifida cannot be cured since nerve tissue damage is irreversible. Antibiotics may be prescribed to treat accompanying infections. Most children suffering from Myelomeningocele, the most common and most severe form of spina bifida, will need lifelong treatment for the variety of conditions that result from nerve and spinal damage. Treatments may include physiotherapy, use of assistive devices such as wheelchairs, crutches or braces, special education and counseling services.

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