Spina bifida: types, causes and treatment

The nervous system is one of the first components that begins to develop during our development, while we are still fetuses. Throughout the first month of pregnancy, in fact, already the neural tube that will shape our brain begins to shut down and the spinal cord.

These will be surrounded and protected by the skull and spine. However, in some cases, a malformation occurs that prevents the neural tube and spine from closing, leaving it open to some extent, so that the nerve bundles it contains can suffer various damage and injury. We are talking about spina bifida.

    What is spina bifida?

    We understand by spina bifida a type of malformation produced during fetal development in which part of the neural tube does not completely close during the first month of pregnancy, so that the spine does not fully protect the nerves that pass through it and the spinal cord is exposed to injury and damage of varying severity. Sometimes this opening is visible, although in other cases it is hidden by the skin.

    Spina bifida may not cause symptoms in some cases, but depending on the type of malformation, its location and the existence of any damage can cause serious problems that are dangerous for the subject. The closer the brain is to the opening, the greater the gravity from symptomatology to damage to more nerves.

    Some of the typical symptoms subjects with spina bifida, especially due to the presence of spinal cord damage due to this malformation, may be the presence of gastrointestinal disturbances, lack of control of the sphincters and urethra, weakness and lack of sensitivity of the lower limbs or areas under the injury and there may even be total paralysis of these areas.

    It should be borne in mind that in some cases the opening of the neural tube is very close to the skull and can lead to disorders such as hydrocephalus or meningitis, with a risk of death for those affected. Learning problems and even intellectual disability can occur in some cases.

      Type of spina bifida

      Spina bifida is a problem that can present itself in different ways, so it is possible to establish different subtypes based on their characteristics.

      1. Hidden spina bifida

      This is the form of presentation that has the least impact on the topic, and it is the most common form of spina bifida manifestation.

      In this case, one or more vertebrae did not form properly and may have openings, although nerve tissue remains inside. The malformation is hidden by the skin. the object it may have holes or bumps on the back. It does not usually cause severe disability, but there may be deformity, incontinence, numbness in a limb, or weakness.

      2. Cystic or open spina bifida

      In this type of spina bifida, part of the spinal cord or meninges protrude from the vertebrae, presenting a high level of danger to the subject who suffers from it when the nerve material protrudes and is not protected. these they usually form a sac filled with cerebrospinal fluid and the excellent material that he can come and observe – outwardly.

      In this guy we can find subtypes.

      Meningocele

      In this case, we find a malformation in which the meninges specific to the spinal cord protrude, The lesion may be exposed or protected by the skin. Instead, what stands out is only the meninges and cerebrospinal fluid, with the nerve bundles still inside the spine.

      Myelomeningocele

      this is the most severe form of spina bifida. In it, the spinal cord is exposed and protrudes through the opening in the spine. In other words, the bundles of nerve fibers do not have bone protection, but are exposed outside the spine. It can cause severe paralysis that prevents bipedal locomotion and loss of sensitivity and strength of innervated areas.

      Possible causes

      Spina bifida it is a congenital disease, but not hereditary. Although the elements and mechanisms that prevent the neural tube from closing are unknown, this is an alteration that occurs during an individual’s fetal development and is generally associated with the presence of low levels of d. folic acid during pregnancy. There is also speculation about the possibility of some sort of genetic influence.

      There are other elements that can be risk factors, Such as the use of certain mind-altering drugs during pregnancy (eg valproic acid), the presence of high fevers during pregnancy, or the age at which pregnancy begins (adolescents and the elderly may be at greater risk ).).

      treatment

      Spina bifida is a disorder that he does not have a totally curative treatment, At least in terms of damaged nerves. However, different types of surgery can be performed to move neuronal material and protect it.

      In people with occult spina bifida, treatment may not be necessary (in fact, in many cases, it is not detected until around old age). Although there may be problems with anchoring the spinal cord which can cause problems during growth. In this case yes surgery should be done.

      In case of open or cystic spina bifida if an intervention is necessary. In the case of myelomeningocele, it is necessary close the tube and protect the neural bundles. At present, it is possible to perform the intervention even at the fetal stage, so that the problem is corrected before childbirth to avoid more damage than already exists, although this are treatments which may involve a certain danger for the fetus and the mother.

      Other spine or bone problems resulting from spina bifida may require treatments and surgeries other than those described above. In hydrocephalus, excess cerebrospinal fluid needs to be treated further.

      Prevention during pregnancy

      Another way to avoid this problem is prevention. It is recommended that during pregnancy pregnant women incorporate folic acid in their diet, Or take supplements of this.

      Special caution is needed with these teenage or very elderly mothers, and in the case of a person with epilepsy taking valproic acid who consults their doctor or psychiatrist for the possible effects of this drug or the possibility of using it. other anticonvulsants as an alternative.

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