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Definition.

Spina bifida (SB) 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.


Three types of spina bifida (from
mild to severe)

1. Spina Bifida Occulta:
2. Meningocele:
3. Myelomeningocele: .

PATHOLOGYCAL
It occurs between days 24 and 28 of gestation
(after union of the egg and sperm),

Usually before a woman even knows she is
pregnant.

Myelomeningocele (the most common and most
severe form of spina bifida) results when the
bones that form the spine (vertebrae) fail to fully
close.

As a result, the spinal cord protrudes through the
opening in the vertebrae, and the baby is born
with a fluid-filled sac on its back.

PATHOLOGYCAL
PATHOLOGYCAL
INCIDENCE

Approximately 40% of all Americans may
have spina bifida occulta,

"spina bifida manifesta," 1/1000 births.
4% have the meningocele form,
96% have myelomeningocele form.


SYMPTOMS

spina bifida occulta :
may cause no symptoms at all, but can
cause a range of neurological problems.
myelomeningocele,
the most serious form of spina bifida, may
include:
muscle weakness or paralysis below the
area of the spine where the incomplete
closure (or cleft) occurs,

SYMPTOMS
loss of sensation below the cleft,
and loss of bowel and bladder control.
(70%-90%) of children born with
myelomeningocele have
hydrocephalus.
Hydrocephalus may occur without
spina bifida, but the two conditions
often occur together.
Diagnosis
Before a child is born, blood tests and
amniocentesis, can indicate the
presence of neural tube defects.
Ultrasound is used to confirm the
diagnosis.
In children with spina bifida occulta, a
tuft of hair or a dimple may indicate
the site of the defect.

Diagnosis
Neurological examination will be conducted to
assess the level of impairment.
Further tests to assess the defect after birth
include :
Spinal x-rays,
Ultrasound,
MRI
CT scans.


Treatment


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

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.
Examination and surgery may be required
to address orthopedic and urologic
problems.
Learning disabilities and developmental
delays are common.
long-term rehabilitation often is required
after surgery


Prognosis

The prognosis for individuals with SB
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 SB
live well into adulthood.

Prevention
The risk for acquiring spina bifida can be reduced
by consumption of folic


Folic acid deficiency in a woman should be
corrected before prenancy, as the disorder starts at
the early phase of

For women who are planning their pregnancy are
recommended to consume folic acid at
0.4mg/day.the folic acid requirement for pregnant
women are 1mg/day.