spina bifida symptoms

spina bifida symptoms

Spina bifida is a congenital disease that affects the child during the first weeks of pregnancy.
Spina bifida comes from a defect in the closure of the neural tube of the fetus.

In patients affected by this disease, the vertebrae do not develop completely. So, there is an opening in neural tube.
This space causes a part of the spinal cord to protrude through the bones.
Spina bifida is a disorder that can be of 4 types:

    Cystic or myelomeningocele,
    Hidden,
     Meningocele,
    Lipomeningocele.

Hidden spina bifida is not usually diagnosed before the patient goes for a back x-ray because of another problem that has nothing to do with spina bifida.
Although this disease of the spinal cord does not cause injuries and does not affect the activity of the body, it may lead to other complications.
Dysraphy is the term used to refer to the problems associated with spina bifida.

Causes of spina bifida

Neural tube defects (myelomeningocele and spina bifida) depend on genetic and environmental factors that are not yet clear.
1 pregnancy out of every 800 can suffer from these diseases.
If, during pregnancy, the mother does not take enough folic acid, the possibility of giving birth to a child affected by spina bifida is higher.

The number of babies with spina bifida has been significantly reduced in recent years thanks to increased use of folic acid during the first months of pregnancy.

Ultrasound and other tests detect dysraphy and offer the mother the possibility of having an abortion.

High risk groups of spina bifida

Children who have a greater chance of being affected by spina bifida are the following:

    Hereditary disorder, there is a genetic factor,
    One of the parents has been affected by dysraphy,
    Firstborn affected by spina bifida,
    Consumption of antiepileptic drugs (such as valproic acid).

Traits and symptoms of spina bifida

It may be that the problems caused by hidden spina bifida influence the nervous system.

The symptoms and consequences of spina bifida are the following:

    Rigidity and back pain
    Pain and weakness in the legs,
    Stunning legs to feet
    Lazy bowel or constipation
    Anatomical malformations of the back, legs or feet,
    A problem in the last part of the spinal cord. It can be detected through the appearance of
    the skin on the lower back.

Next, we present the cutaneous features that make us understand that the individual is affected by spina bifida.

    Hairs on the lower back,
    A red or violet area on the skin underlines the abnormal growth of blood vessels,
    A small cavity in the skin that is located on the lower back, just above the hip,
    A part of the skin becomes clearer with respect to the skin around it,
    Dark spots on the back of the back.
    Those who suffer from spina bifida in the S region or below it, do not have problems of infertility or impotence.
    If the injury affects a higher region, 50% of patients suffer from infertility.
    In case spina bifida is located above L2, there are erection problems.


Complications of spina bifida

In case of hidden spina bifida, we find the following complications:

    Spinal cord union: when affected by this disease, the lower part of the spinal cord binds abnormally to other structures that surround that area. This causes the spinal cord to become longer and damaged.
    The terminal filum becomes thicker: the extreme part of the spinal cord.
    Diastematomielia: this is a disease in which the spinal cord is divided in two by the presence of bones or cartilage.
    Lipomeningocele: a disease in which the spinal cord is affected by a posterior cyst.
    Fat in the terminal phylum: there is fat or cancer in the final part of the spine or in the tissues that surround it.
    Spinal dermal sinus: is a disease in which the skin of the back joins the spinal canal that appears to be a collection of tissues.
    More than half of children affected by spina bifida are allergic to latex due to prolonged exposure to this substance.

spina bifida
In what way do we realize? Diagnosis of spina bifida

Almost 90% of cases of spina bifida is detected through a prenatal ultrasound of the child, in the first 18 weeks of pregnancy.

Other tests:

    The analysis of the mother's blood and amniocentesis measure the alpha-fetoprotein (AFP),
    The chorionic villus sample is the removal of some chorionic villi from the placenta. However, it carries many risks, for example it can lead to a miscarriage,
    Magnetic resonance (MRI)

In open spina bifida, nerves and marrow are not covered by any structure.
It is important that the skin and muscle problem is resolved during the first days of life so that complications do not occur:

    Infections,
    Drainage of excess cerebrospinal fluid,
    Damage to the spinal cord,
    Injuries to the nerves

Folic acid means that the individual does not suffer from spina bifida.

Folic acid is part of the B vitamins.
If the proper amount of folic acid is taken, most neural tube defects are prevented.
It is necessary to take folic acid every day: for a month before becoming pregnant and during the first three months of pregnancy.

The National Health and Medical Research Council recommends all women who are planning pregnancy or who are very likely to become pregnant to take 0.5 mg of folic acid per day.
Those who are in groups with a higher risk, have to consume a higher dose.

Treatment for spina bifida

There is no treatment that solves the problem of spina bifida.
Treatment options from which we can choose include:

    Surgery: is done to close the injury and to reduce the risk of infection.
    Artificial connection: hydrocephalus is solved through a valve and a duct in the ventricles of the brain, where the spinal fluid is produced. This connection causes excess spinal fluid to pass from the brain to the abdomen.
    Orthopedic surgery: children affected by spina bifida perform surgery on legs and feet to improve mobility.
    Devices for assisted mobility: walking devices or wheelchairs make the child get moving.
    Rehabilitation can reduce stiffness, pain in the patient and can improve blood flow.
    Food and enemas: are used for fecal incontinence.

Surgical intervention in the bladder: causes the size of the bladder to increase and tighten the muscles.
    Self-catheterization and medications for incontinence: can be prescribed for urinary incontinence. Sachets or bladder catheters may be necessary.

The functions of the kidneys, the artificial connection and the spinal column must be closely examined.

spina bifida, spine, lumbar

Hidden bifid spina
Legends about spina bifida

Legend → children born with spina bifida have been born dead or have not survived after childhood.

Reality → the possibility of giving birth to a child killed by spina bifida does not reach 5%. This percentage includes children who have been born with other defects in the body, for example heart problems. The second problem can cause the mortality rate to increase.

Legend → the location of spina bifida along the spine is important to know what the life expectancy is.

Reality → the location of spina bifida does not influence the life expectancy.
This emphasizes how severe the paralysis of the legs and feet will be.
The paralysis is below the injury. So, if it is above, the clinical picture is worse.

Legend → if a child is affected by spina bifida and hydrocephalus, the prognosis (life expectancy) is short.

Reality → Most children born with spina bifida develop hydrocephalus during pregnancy or soon after birth.
The only thing that changes is the treatment: for the majority of children with hydrocephalus an artificial connection will be used.
The presence or absence of hydrocephalus does not influence life expectancy.

brain-hydrocephalus
How long do you live? Life expectancy for a child affected by spina bifida

A study published in 2001 analyzes the survival rate of children with spina bifida between 1957 and 1979.
In a group of almost 118 children, 76% of people affected by spina bifida reach 20-25 years.
The cause of death is a problem that has nothing to do with the activity of the artificial connection.
Today, we can say that most children with spina bifida survive until 20-25 years.

It has been discovered that more than 90% of people who have been born with dysraphy reach beyond the age of 30.
However, some say that this disease does not influence life expectancy.
In reality, there is nothing sure because the studies are recent, they have to be updated and they are incomplete on what concerns the life expectancy.