Spina bifida — all you need to know about spina bifida
What causes spina bifida (Spina bifida)
The modern world consists of people who can have minor deviations in health, does not outwardly manifested, and can have serious malformations. Currently, medicine is, faced with such problems, tries to solve these issues and create a more favorable development. Such a defect as spina bifida is no exception.
What is spina bifida? This is a very rare malformation associated with hypoplasia of the posterior of the spine and neural tube. It is manifested by the fact that through a defect in the bone is bulging incompletely formed spinal cord surrounded by a SAC of your own shells and thin skin.
Manifestations of each form
Spina bifida occulta (hidden form)
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It is characterized by the presence of small cracks in the arches of the vertebrae, usually I lumbar that does not cause bulging of the spinal cord. In the normal development of the nerves and spinal cord the clinical picture is poor, and this pathology can be detected only by x-ray. Sometimes there may be a attachment of the spinal cord for up to the last vertebra in the lumbar spine, when physiologically, it ends at the level of the first vertebrae of this division, free slack down. In this scenario, you may experience moderate dysfunction of the pelvic organs: or bladder or bowel, persistent back pain or weakness in the muscles of the lower extremities. At the birth of this malformation can be suspected by the presence of spots or a hollow on the site of the vertebral anomaly.
Meningocele — this form is characterized by moderate severity, in which the bones of the spine (often in the lumbar region) formed an extensive defect. In this case, leave the sheath of the spinal cord, forming a bag filled with liquid. The walls of this education are solid, arachnoid and soft shell. Himself the spinal cord stays within spinal canal, therefore, to solve this pathology requires surgery to correct the defect and prevent nerve damage. The clinical picture in this form will consist of dysfunction of the pelvic organs, namely the bladder and bowel, and moderate paresis of the lower extremities.
Myelomeningocele (spina bifida cystica)
The most severe of forms. At the mention of a diagnosis of spina bifida just remember this form, because it shows the true essence of this malformation. In this situation, the spinal canal is not completely closed and there is a bulging not only of the membranes of the spinal cord, but his own along with the spinal roots. Outside is a hernial protrusion may be covered by immature skin, and may be either «open book» bulging tissue of the spinal cord all nerves.
Here the symptoms will depend on the level of the violation of nerve pathways. In favorable cases, there is only a violation of functions of pelvic organs, severe paralysis of the lower extremities.
This form of spina bifida involves the presence of several defects, namely:
- Anomalies Chiari — shifting of the spinal cord up, however the infringement of the brain stem and impaired speech and swallowing functions as well as motor disorders in the upper extremities.
- Hydrocephalus — obstruction of drainage CSF fluid from the brain. Requires surgery: the imposition of a shunt to remove excess fluid.
- Precocious puberty, which often occurs in girls in conjunction with hydrocephalus.
- Malformations of the urinary system.
- Malformations of the heart.
- The presence of vision problems.
Diagnosis of spina bifida
All women during pregnancy must pass screening tests that will allow you to suspect an abnormal development of the fetus. To treat them:
- A blood test. In the period 16-18 weeks of pregnancy all women are checking the concentration of a nascent protein. He produces fruit in small quantities, but when there’s an open defect or hypoplasia of the Central nervous system the nervous system the concentration of alpha-fetoprotein increased. There are some errors of interpretation of the results, so you should carefully follow a few points:
- setting the exact period of pregnancy;
- diagnosed multiple pregnancies.
- Prenatal ultrasound examination performed at certain stages of pregnancy, which can diagnose the pathology. Using this method is well visualized brain and spinal cord and vertebral column, resulting in a guaranteed timely diagnosis. For minor defects, namely a latent form may miss pathology.
- Amniocentesis — produce a puncture of the amniotic fluid with a large needle under ultrasound sensor. To resort to this method only the detection in the blood increased concentration of alpha-fetoprotein and ultrasound any defects do not exist. Fluid analyses in the same way that the blood, therefore increasing protein rudimentary evidence of splitting of the vertebral column.
- To identify Spino spina bifida at birth, usually you can visually: the presence of hernial protrusion on the spine, or bag, filled with the spinal cord and nerves, or spot (depression) on one of the sections of the back. When spina bifida latent form may not experience any outward signs, however, with the development of the child, you notice the weakness and inferiority of lower limb function, which gives the right to suspect this defect.
- The final diagnosis should be confirmed by additional studies (x-ray diagnostics, CT, MRI).
The causes of pathology
The development of the fetus occurs each time the programmed mechanism, however, due to adverse factors may crash the right way and there is underdevelopment of the systems of the body.
One hundred percent of the causes of spina bifida has not been elucidated, however, at present there are factors, which may occur to incorrect development of the neural tube.
- Folic acid deficiency. The vitamin b is necessary for the fetus in the first months of development, because it was then laid and differentialsa nervous system. Typically, the first three months before pregnancy and subsequent three months of pregnancy the woman needs to take folic acid, which helps to differentiate nerve tissue.
- Family history of neural tube defects. The family, which already has a child with a defect of the spinal column, increases the risk of having a second child with such a malformation with a 10% probability. If you have two children, this percentage rises considerably.
- Drugs. The admission of a woman during pregnancy anti-allopathic remedies that prevent the development defect of the spinal column, damage in the direction of misuse of folic acid for the development of nervous tissue.
- Diabetes. There is a great risk of spina bifida if the mother’s diabetes with high numbers of glucose in the first trimester of pregnancy. Therefore it is necessary to adjust the concentration.
- Obesity. If women before pregnancy obesity, while it appears the risk of neural tube defects.
- Ethnic origin.
The treatment and subsequent rehabilitation
When placing such a serious diagnosis to start taking immediate action of elimination of the defect. If this defect had been diagnosed during pregnancy, resort to prenatal surgery (currently, the technique is not widely used), which helps to close the defect in the vertebral column of small size.
Delivery if the defect be carried out by caesarean section to prevent spinal cord injury as a result of passage of the fetus through the birth canal.
At the birth of a child with meningo or myelomeningocele is needed for the first 24 hours to perform the operation for correcting the defect. Emergency treatment prevents even greater damage to the spinal cord and the development of complications.
Remember, surgical treatment will not restore lost functions, and eliminate the cause of the disease.
Subsequent treatment includes rehabilitation: physiotherapy, physiotherapy and the wearing of the corset.
Video: In essence-utero correction of spina bifida
To prevent development of spina bifida in children need to follow a few steps:
- Planning of pregnancy — prior to conception of the child should be fully tested for various diseases, when their presence is required to eliminate them.
- Prenatal diagnosis monthly consultation with a doctor obstetrician-gynecologist, to pass the necessary examinations.
- The intake of folic acid 3 months before pregnancy and the first 3 months of pregnancy.