What is spina bifida?: types, causes and treatment

What is spina bifida?

Spina bifida, defined byManual MSD, is the defective closure of the spine and occurs before birth. It is one of the most common spinal injuries in general terms and its severity varies from being hidden, to a severe neurological disability that can lead to death.

Spina bifida can contain within it spinal cord, meninges or both and although it is covered by skin it is very easy to break, so people who suffer from it have serious risks of contracting meningitis.

Causes of spina bifida

The causes of spina bifida can have several influential factors, it seems to have a genetic component and also other motivating elements to the appearance of this, during the culmination of the first month of gestation of the infant.

Next, we will mention and explain the main determining causes in the appearance of spina bifida.

Genetic and familial factors

The genetic factor determines that parents who have conceived a child with spina bifida have an increased risk of having a second with the same neural tube defect. The reason for its appearance is unknown with certainty, but many doctors believe that the combination of one or more genes is the main reason for this condition.

There are studies of Genetic tests: MTHFR gene , which have identified some of the genetic factors that influence it, but the observation is also made that they tend to vary greatly depending on dozens of genes in the individual with spina bifida and their mothers, these being those who can influence the risk.

Polymorphisms in the MTHFR gene are closely associated with the risks of spina bifida, although most people who have alterations in this gene do not have the formation of this defect.

Folic Acid Deficiency

Folic acid is a B group vitamin, which is supplied for its influence in helping to prevent this type of congenital conditions during pregnancy. Taking this supplement does not guarantee having a healthy baby, but it does significantly increase the chances of not presenting this pathology and provides many necessary care in the development of the baby.

For these reasons, folic acid is recommended before the pregnancy process, during planning. And it is the first thing they indicate when a pregnancy is determined.

radiation exposure

Another reason for the appearance of this malformation are environmental factors such as radiation exposure during pregnancy. Ionizing radiation can have serious health consequences, especially at this vulnerable stage of development.

In a research work developed by the Donostia Hospital on Pregnancy and radiation , they explain that for there to be a latent risk of congenital malformations at any stage of pregnancy, exposure must be greater than 100 mSv (millisievert, one thousandth of a sievert) and the time of the dose will also influence.

Obesity

In the study carried out entitled “Pregnancy Obesity as a Risk Factor for Structural Birth Defects” , the verification that obesity increases the risk of spina bifida and other possible defects is exposed.

For the researchers and the subjects under study, it is shown that women who were obese at the beginning of pregnancy, demonstrated a greater risk in the development of spina bifida or other neural tube defects. They could also develop many other types of abnormalities.

Diabetes

Not having blood glucose controlled in the correct parameters increases the risks of having a baby with spina bifida. In fact, the risk in general is for the development of certain congenital defects, where this is only included as one of the possible ones.

In fact, at the University of Newcastle, there is a statistical study where they state that women without diabetes have 19 per 1,000 births, congenital defects in newborns. While those who suffer from this pathology increases to 72 per 1000.

On the other hand, Mother to Baby published an informative article entitled ” Diabetes and gestational diabetes “ , where they clearly explain that women who have less control over their pathology in the first trimester will have a 20% greater chance that the baby will develop Congenital malformations.

Drugs

There are medications, such as anticonvulsants that seem to affect the neural tube if taken during pregnancy, which is why it is capable of developing this malformation in babies. Treatments for psoriasis and hormonal are also influential in this type of condition.

hyperthermia

Hyperthermia is the increase in body temperature, and the willingness for this to happen during the first weeks of gestation can increase the risk of developing spina bifida.

It can be an increase due to fevers or also external agents, such as the use of saunas or jacuzzis, which leads to an increase, although slight, but existing.

Types of spina bifida

There are mainly three types of spina bifida that can be distinguished among this malformation. Both have different aggravating levels and characteristics that determine and define them. Next we will talk about them.

spina bifida occulta

Spina bifida occulta is the most common to develop, and its name precisely indicates that the malformation is “hidden” because it is covered by a layer of skin.

It can also be called spina bifida escondida and although the nerves and spinal cord may have developed correctly, the spine has an abnormality in its bone formation.

There are cases that even individuals do not realize that they suffer from this malformation and it is because it is the one that produces the least risks and complications. It can be determined because through the time of human development, pain in the back, weakness in the legs and discomfort in the bladder can occur.

Myelomeningocele

It is the most common and also the most serious. It is the type of spina bifida where the spinal cord is exposed through an opening in the spine, leading to partial or complete paralysis of the parts of the body below the spinal opening.

The disabilities that occur can be moderate or severe and are detected at birth of the individual. Antibiotics are usually given immediately to prevent meningitis from developing and surgical repair could reduce the risk of infection, but it must be done 72 hours after birth.

Meningocele

In this case there is the presence of a sac of fluid that is on the back and comes out through an opening in the back. In it the spinal cord is not present, so the damage to the nerves is usually quite scarce or even null.

The disabilities present are minor and although in many cases the bag is not covered with skin, the symptoms are usually similar to those present in cases of Myelomeningocele.

Closed neural tube defects

This malformation is an abnormality that presents a malformation of fat, bone and membranes of the spine. The bones of the spine are not completely formed, so the spinal cord and the tissues that cover it protrude through a hole in the back.

In the Medwave Biomedical Journal there is an article entitled “Neural tube closure defects” , where there are structural defects in the nervous system and it involves the action of numerous genes.

“The defective closure will cause different manifestations according to the closure site, so a superior closure defect causes anencephaly incompatible with life, and a defective closure in the lower end of the neural tube causes lumbosacral myelomeningocele, generally associated with partial paralysis. or complete lower limbs”.

Spina bifida treatment

Not all individuals born with this malformation will have the same needs or characteristics, so the treatments are adapted to each one of them.

The level of severity is usually different and below we will mention the most applied treatments in this type of case.

Closure Surgery

Surgical repair is something that is initially considered to prevent neurological damage from progressing, especially in the case of spina bifida occulta. Urological, orthopedic, pediatric and even psychological evaluations are carried out.

Doctors have even begun to use fetal surgery to treat myelomeningocele, performed inside the uterus and closing the opening in the developing baby. They have the theory that the earlier they are corrected, the lower the risks and the better the result.

Ventricular Shunt Valve

This type of surgical treatment is used to control the amount of cerebrospinal fluid in the body and is usually applied when spina bifida occurs in conjunction with hydrocephalus.

A shunt is installed in the head to remove the fluid, which would reduce pressure and swelling in the brain. Hydrocephalus is usually the consequence of existing imbalances in the body, even triggered by pathologies that cause obstruction in the liquid absorption points, as we will know how to recognize in spina bifida.

Wheelchairs, crutches and braces

There are people who will require assistive devices of this type. They are usually necessary, due to the limitations that develop and the complications that some types of spina bifida bring with them, where paralysis or serious defects in the spine occur.

Depending precisely on the degree of complexity that is presented, the use of crutches or in other cases of wheelchairs will be applied.

Physical activity

The treatment of paralysis when it is present in the individual and the underlying problems of a bladder and intestinal nature, usually occur shortly after birth, which requires the application of certain special exercises for legs and feet, where it is helped the individual to get up to walk using tools such as crutches, but improving the possibilities.

Skin care

In Centers for Disease Control and Prevention , they develop an article with an extensive study on Spina Bifida Health Problems and Treatments , where they explain that in patients with this malformation sores, blisters and burns appear in certain areas of the body, where It is difficult for them to notice it because of the little sensitivity they have.

For skin care it is recommended:

• Check regularly.
• Avoid hot water baths.
• Ensure that the shoes used are the correct size.
• Use sunscreen.

Control and constant medical monitoring

Constant monitoring in these cases is highly recommended to avoid the production of complications in the individual’s body. The follow-up and observation of professionals and a team committed to the patient and her well-being are necessary.

How to prevent spina bifida?

Although, as we have mentioned, the determining factors that produce spina bifida in the gestation process are not managed with certainty, it is recognized that there are ways to reduce the possibility of this malformation. These preventive forms will be mentioned and described below.

Consume folic acid during pregnancy

As we mentioned previously, folic acid is a supplement that is recommended for consumption during the gestation period. This type B vitamin positively influences the development of pregnancy, and the care of those involved.

There are even sources that indicate that taking care of the body with the consumption of folic acid before pregnancy reduces the possibility of developing spina bifida by 72%.

Follow a healthy diet

In the Nutriwhite Blog , they even describe a recommended diet to prevent spina bifida, where they recommend care for a healthy intestine by avoiding foods that cause food sensitivities or inflammation, in order to be able to absorb the nutrients from all the foods consumed and multivitamin supplements. .

Avoid alcohol and cigarette consumption

Smoking cigarettes or consuming alcoholic beverages during pregnancy is something that is not recommended and is fought by campaigns by all doctors and gynecologists.

Also any product derived from tobacco, since all these elements threaten the integral health of any person.

Avoid taking non-prescription drugs

The consumption of medicines without prescription or medical control, are usually a risk to health. Especially when we are unaware of their active components and consume doses that follow an ignorant criterion.

Maintain a suitable weight

As previously mentioned, obesity increases the risk of developing pathological malformations during pregnancy, so maintaining a weight within the correct values based on our height and diet will reduce the risk of spina bifida.

Avoid excessive increase in body temperature

Hyperthermia is counterproductive for the correct development of pregnancy, so taking care of diseases and infections that cause high fevers and not exposing ourselves to high temperatures such as steam rooms, saunas or jacuzzis will allow us to reduce the risks of developing this malformation.