Cause of Spina Bifida

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About Spina Bifida

Spina bifida is a neural tube defect (a disorder involving incomplete development of the brain, spinal cord, and/or their protective coverings) caused by the failure of the fetus's spine to close properly during the first month of pregnancy.

Infants born with Spina Bifida sometimes have an open lesion on their spine where significant damage to the nerves and spinal cord has occurred.

Although the spinal opening can be surgically repaired shortly after birth, the nerve damage is permanent, resulting in varying degrees of paralysis of the lower limbs.

Even when there is no lesion present there may be improperly formed or missing vertebrae and accompanying nerve damage. In addition to physical and mobility difficulties, most individuals have some form of learning disability.

The three most common types of Spina Bifida are: myelomeningocele, the severest form, in which the spinal cord and its protective covering (the meninges) protrude from an opening in the spine; meningocele in which the spinal cord develops normally but the meninges protrude from a spinal opening; and occulta, the mildest form, in which one or more vertebrae are malformed and covered by a layer of skin.

Spina Bifida may also cause bowel and bladder complications, and many children with Spina Bifida have hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain).

Treatment

There is no cure for Spina Bifida because the nerve tissue cannot be replaced or repaired. Treatment for the variety of effects of Spina Bifida may include surgery, medication, and physiotherapy.

Many individuals with Spina Bifida will need assistive devices such as braces, crutches, or wheelchairs. Ongoing therapy, medical care, and/or surgical treatments may be necessary to prevent and manage complications throughout the individual's life.

Surgery to close the newborn's spinal opening is generally performed within 24 hours after birth to minimize the risk of infection and to preserve existing function in the spinal cord.

Prognosis

The prognosis for individuals with Spina Bifida depends on the number and severity of abnormalities. Prognosis is poorest for those with complete paralysis, hydrocephalus, and other congenital defects. With proper care, most children with Spina Bifida live well into adulthood.

Research

Neural tube defects (NTDs) are one of the most common birth defects. NTDs result when the neural tube (which includes the spinal cord and brain) fails to close during the first month of embryonic development.

NTDs include several disorders ranging from spina bifida (incomplete closure of the bones around the spinal cord that can lead to paralysis) to a lack of a cranium (the bones of the head) and its contents, called anencephaly.

Several studies and clinical trials have shown that 50% or more of NTDs can be prevented if women consume a folic acid-containing supplement before and during the early weeks of pregnancy.

Reference for Spina Bifida Article

MRC Vitamin Study Research Group. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 1991;338:131–7.
Czeizel AE, Dudás I. Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N Engl J Med 1992;327:1832–5.
National Institutes of Health

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