Causes

GIGER MD® for Spina Bifida
Causes

Spina bifida is a birth defect, which often has serious consequences for those affected. Learn more about the causes, symptoms and treatment!

Occurrences/Causes

Spina bifida occurs in about 3.2 per 10,000 births in the USA. It is much more common in whites than in blacks or Asians. There is a familial tendency to the occurrence of this disorder, although multiple environmental factors and exposure to many toxins/ medications/ infections have been suggested as contributing to the development of spina bifida. It is now established that folic acid, given before and during the early stages of pregnancy can substantially reduce, by perhaps over 70%, the occurrence of the disorder in high risk and first pregnancies.  

Prenatal diagnosis is usually possible via the measurement of fetal protein leaking from the open neural tube into the mother’s blood stream or amniotic fluid surrounding the fetus. Ultrasound techniques are now so highly developed that some experienced sonographers report nearly 100% detection rates prenatally.

Clinical examination of the infant with myelomeningocele reveals loss of sensation or motor function below the level of the defect, as well as weakness of the legs, bowel and bladder malfunction, and possible deformities of the legs. The extent of these abnormalities depends greatly on the level of the spinal cord malformation. Hydrocephalus occurs in at least 75-90% of infants with spina bifida, resulting in decreased mental function, deterioration of vision, and excessive head growth in untreated children. Over 90% of patients with myelomeningocele have a bladder and bowel that function abnormally due to lack of nerve control. This can result in chronic kidney infection and eventual kidney failure without careful treatment.  

All infants with myelomeningocele also have a Chiari malformation of the hindbrain (as described above). Symptoms may include interruption of breathing periodically, slow heartbeat, difficulty swallowing, floppiness or stiffness of muscles, and abnormal eye movements. 

The first and most important early measure in treatment in myelomeningocele is surgical closure of the spinal defect as early as possible, to prevent infection and further deterioration of function. If, as usually happens, hydrocephalus also occurs, a shunting procedure to remove excess cerebral fluid and relieve high pressure must be performed.

Careful followup in a multidisciplinary health care setting, including a pediatric neurosurgeon, orthopedist, urologist, social worker and therapists can prevent or provide for early treatment of already noted problems, as well as delayed complications such as tethered cord, cavities within the spinal cord (syringo or hydromyelia), spasticity, mutiple types of eye complications, seizures, learning disabilities, and social or emotional problems resulting from the child’s disability.

Parents should be made aware that despite the many problems and potential complications associated with spina bifida, the prognosis for their child is usually far from grim. The potential for a high quality of life has been documented. Operative mortality for primary closure of the spinal defect is close to zero, and survival rate for the first 2 years of life is over 95%. Eighty percent or more will have normal intelligence, and the majority complete high school. Eighty five percent will walk with or without some form of assistance (such as crutches or braces). Eighty percent of patients will gain partial control of their bladder with the use of drugs and clean intermittent catheterization. The prognosis of newborn infants with myelomeningocele is better at this time that at any time in history.

Spina Bifida is a very serious condition that can be developed during pregnancy. Although Spina Bifida can lead to a life-long disability, it can also be a harmless condition with no disibilities at all.

There is no single known cause of SB. Research continues into the effects of factors such as heredity, nutrition, environment and pollution, and physical damage to the embryo. The main cause known at the moment is a lack of certain vitamins, such as folic acid, which is crutial for the devlopment of the fetus’s nervous system. Spina Bifida is where the spinal process fails to join together, which leaves a gap in the spine.

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