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Spina bifida is a common birth defect, and it is manageable. It is an opening in the spinal column. The spinal cord forms during the first few weeks of gestation. In addition to genetic and environmental associations, it is felt that folate deficiency may be an underlying factor in preventing the spine’s normal development.

 

The aperta form of spina bifida is when not only is the spinal column open, but the spinal cord is incompletely formed and is exposed to the air. The much more common form is the closed or occulta form which is probably of little significance and seen widely in spina bifida patients.

 

Other problems which are common with spina bifida patients include hydrocephalus, syringohydromyelia and Chiari Malformations. Bowel and bladder functions, both extremity and spine related problems and respiratory and swallowing difficulties are associated to the disturbance in the nervous system.

 

Spina bifida can be diagnosed before birth with a high resolution ultrasound or by detecting an elevation of maternal alpha fetal protein levels. Sometimes it is not known until after birth. Most children born with spina bifida should be aggressively treated both medically and surgically. Early closure of the back and spinal cord is imperative, and hydrocephalus treated if necessary. This operation necessary to prevent infection or ongoing trauma to the exposed spinal cord. Hydrocephalus is usually present in 80-90% of children with spina bifida and needs to be treated before discharge from the hospital.

 

Another problem common in children with spina bifida is Chiari Malformation. There are different forms of Chiari Malformations, but most are either Type I or Type II. All children with spina bifida have some degree of Type II malformation. Sometimes the malformation can be seen radiographically, but may not be causing the child any symptoms. It may not require treatment. Symptoms of Chiari Malformations include aspirations, apnea, neck pains, and complaints of weakness or sensations in the arms. Surgery is reserved for only the most aggressive or advanced cases.

 

Spina bifida impacts numerous body functions. Early intervention with physical therapy, assistance with continence, and bracing for the spine or legs will follow surgery. A multidisciplinary team of physicians, specialists and therapists will provide the treatment necessary.

 

Since spina bifida is a birth defect, and the child grows with its problems. Most will be ambulatory without aid, but may need a wheelchair or bracing. Incontinence is controlled with catherization. And while they might not be considered “normal”, they are special. Their intelligence and enthusiasm for life will keep them at a competitive scale to their peers.

 
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