Spina Bifida is a congenital or inborn defect in the opening of the spinal column. The most severe form of Spina bifida is myelomeningocele. Most kids who were born with this defect were able to survive but they suffer various disabilities like paralysis, hydrocephalus, Chiari II malformation, mental retardation, and difficulty with bladder and bowel control.
Causes of Spina Bifida Myelomeningocele
During the first four weeks of pregnancy, development of the spine occurs where two sides of the spine joins together to cover the spinal cord, nerves and the meninges. Spina Bifida actually refers to a birth defect which involves an abnormal formation of the spine where part of the spine is not completely close.
Myelomeningocele is a common type of Spina Bifida. This is a defect where the bones of the spine do not completely develop thus leading to an opening in the spine. The result is that the spinal cord sticks out of the child’s back. These cases may occur once in every 800 infants.
Most common complications for infants with myelomeningocele are hydrocephalus which affects as many as 90% of infants or children. Other disorders may occur like hip dislocation and syringomyelia.
There is no known cause of myelomeningocele. But it is seen that low levels of folic acid in a woman during early pregnancy have high chances of developing this defect with their unborn child. It is a known fact that the vitamin folic acid is vital for spinal cord and brain development.
There is a study which started year 2002 that is called MOMS or Management of Myelomeningocele Study. It is sponsored by NIH and its purpose is to evaluate the best treatment for myelomeningocele whether it is surgical repair right after birth or fetal surgery. The trial showed that prenatal surgery lessens the need to divert fluid away from the brain; improved motor function and mental development; and increase the chances of the child walking without assistance.
MOMS trial also prove that factors that leads to problems like hydrocephalus and Chiari II malformations develops during the second half of pregnancy so that closing the fetus back early may let some nerve function to be restored in pregnancy and thus reverse the development of this serious condition ( New England Journal of Medicine 2011 ).
Other research indicates that possible environmental factors like radiation can cause this condition. Also if a child born with myelomeningocele in the family then future children in that family is at higher risk with the condition but in most cases there is no family connection.
Symptoms of Spina Bifida Myelomeningocele
Spina Bifida Myelomeningocele symptoms include the following – weakness of the hips, feet or legs of a newborn; complete or partial paralysis of the legs, complete or partial lack of feeling or sensation, and loss of bowel and bladder control.
Diagnosis of Spina Bifida Myelomeningocele
Prenatal screening can help diagnose the condition. Pregnant women during its trimester can have a blood test named quadruple screen. This test screens for Down syndrome, myelomeningocele and other congenital disease in the baby.
Myelomeningocele can also be detected after the child is born. Tests done after the baby is born may include MRI, CT Scan, Ultrasound and X-rays in the spinal area.
Treatments For Spina Bifida
Surgery is usually recommended to treat the condition and it is done right after birth. This calls for careful procedures to lessen damaged to the expose spinal cord. For children who develop hydrocephalus it may require ventricular peritoneal shunt placed which will help drain the extra fluid in the brain. Antibiotics are usually used to prevent infections like urinary tract infection and meningitis.
Most of these children need lifelong treatment for problems that results from the injury to the spinal nerves and cord thus follow-up examinations usually continue through out the child’s life.