SB (SB) is a birth defect. It is a problem with how the spine and spinal cord form. SB can start to form in a fetus before the mother even knows she is pregnant. In some cases, structures that should be inside the spinal canal can slip out, such as:
- The thin layer that surrounds the spinal cord
- Nerve roots that link nerves to the spinal cord
- The spinal cord
- Back bones—may be deformed
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There are three kinds of spina bifida:
- Occulta—small defect in one or more backbones, least severe form, usually no health problems
- Meningocele—membranes poke through an open part of the spine and can form a cyst
Myelomeningocele—most severe form of SB , membranes poke through and contain nerve roots or spinal cord and can lead to:
- Paralysis and lack of bowel and bladder control may occur—often not cured by surgery
- Hydrocephalus —a build up of fluids in the brain that raises pressure on the brain
Occulta may not have any symptoms. Some with this type may never know they have SB. There may be a small tuft of hair or change in skin color over the low back.
The symptoms of meningocele and myelomeningocele are:
- Sac filled with fluid leading out from the baby's spine
- Spinal cord and tissue that may stick out of the back
A blood test of the mother before birth can predict the risk of SB. If the test predicts a high risk of neural tube defects, then two more tests may be done:
- Amniocentesis —a sample of the fluid around the baby is taken to measure for factors that point to problems of the spine
- Ultrasound —a test that uses sound waves to look at the fetal spine
A diagnosis before birth can help you and your doctor make plans. Surgery may be needed soon after birth.
After Birth Testing
After birth, meningocele and myelomeningocele can be seen. Many tests will be needed to find out which bones and nerves are involved. The kidneys may also be harmed. They will need to be watched closely.
Most children with occulta SB will never be diagnosed. It rarely causes any symptoms. It also has few problems. It may be found during a routine medical exam or x-rays of the lower back.
Occulta SB doesn’t need treatment.
Meningocele SB is treated with surgery. It is done to remove the cyst. This form of SB can be treated.
Treatment for myelomeningocele SB is complex. It may include:
During surgery, the nerves, membrane, and spinal cord are put back into place. It will be done within 24-48 hours after birth. In some cases, it may be done before birth.
Surgery is done as early as possible to prevent further nerve damage. It cannot reverse damage that has happened.
More serious forms of SB may require more surgeries throughout childhood.
Therapists will teach parents how to exercise the infant's legs and feet. Walkers, braces, and crutches will often be needed to let the baby move around.
Complications of SB can be ongoing and extensive. It will be important for you to work with a team of doctors. You will need to get help for your child's physical needs and emotional support for you and your family.
To lower the chance that your baby will be born with SB:
If you plan to have a baby, take
supplements before the baby is conceived. They should also be continued throughout the pregnancy. A vitamin supplement that has folate may be the best method of getting folate, but you can get it from food as well.
Foods with folate
- Leafy green vegetables
- Orange juice
- White flour products and cereals fortified with folate
- Plan your pregnancy . Talk to your doctor if you have any of the risk factors listed above. Ask your doctor if any medicine that you are taking raises the risk of having a baby with SB .
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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March of Dimes http://www.marchofdimes.org
Spina Bifida Association of America http://www.spinabifidaassociation.org
Sick Kids—The Hospital for Sick Children http://www.sickkids.ca
Spina Bifida and Hydrocephalus Association of Canada http://www.sbhac.ca
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