What Is Spina Bifida

There are 70,000 Americans that live with spina bifida but what is it, what are its affects, and how do you deal with it? First, we need to understand what spina bifida is before we can understand the effects that it causes. Spina bifida means a cleft spine, which is an incomplete closure in the spinal column. There are three types of spina bifida and ranges from mild to severe depending on which type you have. Those three types are:

1. Spina Bifida Occulta which is an opening in one or more of the vertebrae (bones) of the spinal column without apparent damage to the spinal cord.

2. Meningocele that is meninges, or in laymen's terms, a protective covering around the spinal cord, has pushed out through the opening in the vertebrae in a sac called the "meningocele. With this type, the spinal cord remains intact. This form can be repaired with little or no damage to the nerves.

3. Myelomeningocele being the most severe form of spina bifida, in which a portion of the spinal cord itself protrudes through the back. In some cases, sacs are covered with skin; in others, tissue and nerves are exposed.

Spina bifida happens in the embryo where there is a tiny ribbon of tissue that folds inward to form a tube. This structure, called the neural tube (NTD), forms by the 28th day after conception. When this process goes awry and the neural tube does not close completely, defects in the spinal cord and in the vertebrae can result.

Spina bifida usually is an isolated birth defect. Although scientists believe that genetic and environmental factors may act together to cause this and other NTDs, 95 percent of babies with spina bifida and other NTDs are born to parents with no family history of these disorders. While spina bifida appears to run in certain families, it does not follow any particular pattern of inheritance. If one child has spina bifida, the risk of recurrence in any subsequent pregnancy is greatly increased, to about one in 40. If there are two affected children, the risk in any subsequent pregnancy is about one in 20. Spina bifida also can occur as part of a syndrome with other birth defects.

According to the Spina Bifida Association "Spina Bifida occurs in 7 out of every 10,000 live births in the United States. Birth certificate data from the National Vital Statistics System, a component of the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), indicate a drop in the rate of Spina Bifida; however, Spina Bifida is considered to be underreported on birth certificates so the drop in the rate could be due to lack of reporting, not an actual decrease in occurence. In addition, a number of Spina Bifida pregnancies are voluntarily terminated and we cannot be certain how many pregnancies are terminated versus carried to term."

Treatment for Spina bifida varies depending on the type. Occulta usually requires no treatment. Meningocele, where the spinal cord is not involved, can be repaired by surgery, usually with no paralysis. Most children with meningocele develop normally. However, affected children should be evaluated for hydrocephalus (water on the brain) and bladder problems so they can be treated promptly. A baby with myelomeningocele, the most serious, usually requires surgery within 24 to 48 hours after birth. Doctors can surgically tuck exposed nerves and the spinal cord back inside the spinal canal and cover them with muscle and skin. Doing surgery, promptly, helps prevent additional nerve damage from infection or even trauma. However, if nerve damage that already has occurred, it cannot be reversed and limb paralysis and bladder and bowel problems usually remain.

For those children where surgery was possible, soon after the surgery a physical therapist teaches parents how to exercise their baby's legs and feet to prepare for walking with leg braces and crutches.

According to KidsHealth, "no one is really sure why some kids are born with spina bifida, but doctors and scientists have found some possible reasons. They've learned that folic acid is very important, especially when a baby is growing inside its mother. Folic acid is one of the B vitamins found in foods like broccoli, spinach, egg yolks, and oranges. If a woman doesn't have enough folic acid in her diet while she's pregnant, she may be more likely to have a baby with spina bifida. Luckily, special vitamins containing folic acid are available for pregnant women. A woman who has a high fever early in her pregnancy also may be at higher risk of having a baby who has spina bifida. Scientists are also studying the roles that genes, certain chemicals, and medicines might play in causing spina bifida."

Spina bifida often can be detected before birth using two or more tests. Now most health care providers routinely offer pregnant women a blood test called the maternal serum alpha-fetoprotein (MSAFP)