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Spina bifida is a congenital disorder
caused by an incomplete development of the spinal column
during the first month of pregnancy. There are three
types of spina bifida:
- Spina Bifida Occulta -- the mildest form, in which one or more vertebrae are not closed, but there is no protrusion of the spinal cord and meninges (a protective covering around the spinal cord).
- Meningocele -- the meninges protrude from the opening in the vertebrae but the spinal cord remains intact.
- Myelomeningocele -- the most severe form, in which a portion of the spinal cord and meninges protrude from the opening in the spine.
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- Infants born with spina bifida have a skin dimple with a tuft of hair on the back and a protruding sac over the spine. In some cases, the sacs are covered with skin.
- There is a higher risk of infection if the spinal cord and nerves are exposed.
- Besides the spina bifida, other defects can occur. These include hydrocephalus, Chiari malformation and syringomyelia (accumulation of cerebrospinal fluid within the spinal cord). About 80 to 90% of children with myelomeningocele have hydrocephalus
- Nerve and spinal cord damage results in varying degrees of paralysis of the lower limbs, as well as loss of bladder and bowel control
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- Incidence -- spina bifida affects approximately one out of every 1,000 births in the United States. Most cases (about 95%) are myelomeningocele.
- Causes -- the cause is uncertain. Genetic and environmental factors may play a role.
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- Visualization of the defect or sac on the back
- Spine X-Ray shows the bony defect
- A spine MRI scan is used to detect the damage of the spinal cord and nerve tissues.
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- Family history of spina bifida
- Increased maternal or paternal age
- Folic Acid Deficiency before and during the first month of pregnancy
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- In meningomyelocele, prompt surgery must be performed within 24 hours after birth to prevent infections and further damage to the spinal cord.
- If the child has a permanent disability, physical therapy, proper braces or a wheelchair can improve the mobility of the patient. Many children with myelomeningocele need medications and training to manage their bladder and bowel functions.
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Folic Acid Deficiency may increase the risk of neural tube defects, including spina bifida, so it is recommended that all women of child-bearing age consume 0.4 mg of folic acid daily to reduce the risk of having a pregnancy affected by a neural tube defect.
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