What is Spina Bifida?
Spina Bifida is a birth defect in which the backbone and spinal canal do not close before birth. Normally, during the first month of a pregnancy, the two sides of the spine join together to cover the spinal cord, spinal nerves and meninges (the tissues covering the spinal cord). Spina bifida refers to any birth defect involving incomplete closure of the spine. Myelomeningocele is the most common type of spina bifida. It is a neural tube defect in which the bones of the spine do not completely form, resulting in an incomplete spinal canal. This causes the spinal cord and meninges (the tissues covering the spinal cord) to stick out of the child's back. (1)
_
The Different types of Spina Bifida
-Occulta- A relatively harmeless form of Spina Bifida where there is a small gap or defect in the vertebrae that make up the spine. The nerves and spinal cord are usually normal and there is no opening on the back. Due to these symptoms Occulta is also known as hidden Spina Bifida. Motor and Sensory impairments may not be evident at birth. "Subtle,progressive neurologic deterioration often becomes evident in later childhood or adulthood. In many instances, Spina Bifida Occulta is so mild that there is no disturbance of spinal function at all. Occulta can be diagnosed at any age."(3)
-Meningocele- There is an opening in the spine where the meninges, or protective coverings, come through like a sac. The sac is filled with cerebrospinal fluid and there is usually nonerve damage. Minor disabilities may occur but could increase with age.(3)
-Myelomeningocele- The meninges and spinal nerves come through the open part of the spine. This is the most common and most severe type of Spina Bifida which causes nerve damage and severe disabilities.(3)
-Occulta- A relatively harmeless form of Spina Bifida where there is a small gap or defect in the vertebrae that make up the spine. The nerves and spinal cord are usually normal and there is no opening on the back. Due to these symptoms Occulta is also known as hidden Spina Bifida. Motor and Sensory impairments may not be evident at birth. "Subtle,progressive neurologic deterioration often becomes evident in later childhood or adulthood. In many instances, Spina Bifida Occulta is so mild that there is no disturbance of spinal function at all. Occulta can be diagnosed at any age."(3)
-Meningocele- There is an opening in the spine where the meninges, or protective coverings, come through like a sac. The sac is filled with cerebrospinal fluid and there is usually nonerve damage. Minor disabilities may occur but could increase with age.(3)
-Myelomeningocele- The meninges and spinal nerves come through the open part of the spine. This is the most common and most severe type of Spina Bifida which causes nerve damage and severe disabilities.(3)
Symptoms
-A sac sticking out of the mid to lower back
-Abnormal feet or legs, such as clubfoot
-Build up of fluid inside the skull (hydrocephalus)
-Hair at the back part of the pelvis called the sacral area
-Dimpling of the sacral area
-Latex allergies(2)
-A sac sticking out of the mid to lower back
-Abnormal feet or legs, such as clubfoot
-Build up of fluid inside the skull (hydrocephalus)
-Hair at the back part of the pelvis called the sacral area
-Dimpling of the sacral area
-Latex allergies(2)
Typical Develpment
Typical Development for an Infant: 0 - 3 months old
Physical Skills:
-Raises head & chest when on stomach
-Stretches & kicks on back
-Opens and shuts hands
-Brings hands to mouth
-Grasps and shakes toys(1)
Social Skills:
-Begins to develop a social smile
-Enjoys playing with people
-More communicative
-Moe expressive with face and body
-Imitates some movements and expressions(1)
Sensory Milestones:
-Follows moving objects
-Recognizes familiar objects and people at a distance
-Starts using hands and eyes in coordination
-Prefers sweet smells
-Prefers soft to coarse sensation(1)
What to Expect as Your Child Develops
Since no two diagnosis are alike it is difficult to generalize development but here are some common issues your child may develop as they grow.
Gross-motor skills and coordination-
Decreased sensation below the spinal defect may cause trunk and pelvic
instability. This weakness can pervade the entire body during a child's growth
and development. This would affect a child's ability to play, move, self-care
tasks, self- image and independence.(2)
Fine motor skills-
When the large muscle groups are having a rough time of it, so do the small
ones. Fine motor skills include hand use and movement involving precision and
accuracy. Fine motor skill are needed for education, play, and self-care
skills.(3)
Lower body paralysis and/or loss of sensation-
More typically found in myelomeningecle form this is probably one of the scariest and heart wrenching thoughts for a parent. Depending on where the paralysis starts may mean the difference between independent living some day or full dependence. Paralysis can affect many areas of a child's life: play, mobility, access to resources, socialization, and independence.(3)
Bladder and bowel control-
In many cases of spina bifida there is decreased bladder and
bowel control if there is any. Your physician and urologist should provide you
with a individualized program or routine to help you and your child to achieve
some level of continence or management. Roles that may be impacted by a lack of bladder and bowel control are socialization, self-image, and independence.(2)