Spina bifida

21:54 - 4 May , 2021

Disease

What is Spina bifida?

It is a congenital condition that prevents the spine and spinal cord from developing properly due to a neural tube anomaly, which is the embryonic construction that becomes the fetus’s brain and spinal cord. This condition usually appears in early pregnancy and is characterized by the failure of the spinal cord to close properly. Depending on the size and type of the anomaly, its difficulties, and its location, it can be slight, moderate, or severe. Although the cause of spina bifida is unknown, some risk factors can contribute to its appearance, such as:
  • Family history.
  • Low levels of folate (vitamin B-9).
  • Diabetes.
  • Hyperthermia (increased temperature), either due to fever or the use of jacuzzis, saunas, or steam rooms, at the beginning of pregnancy.
  • Intake of some anticonvulsant medications.
  • Overweight and obesity.
Spina bifida is usually classified into:
  • Occult: it is the most frequent and is distinguished by a small opening in one or more vertebrae.
  • Open or cystic: it is the most serious and appears as a lump in the form of a cyst on the baby's back because the spinal canal is completely open in various vertebrae, either in the lumbar or mid-back area.

Symptoms

The symptoms are not usually the same in all cases, since it depends on the type of spina bifida in question:
  • Occult: Usually there are no symptoms because the spinal nerves are not damaged. However, some signs may be noticed on the baby's skin above the spine, an abnormal strand of hair, or a small birthmark.
  • Open or cystic: the membranes that surround the spinal cord stand out and form a kind of protuberance covered with skin or can leave the nerves exposed.
Potential risks:
  • Difficulty walking.
  • Limited movement.
  • Musculoskeletal system complications, such as:
  • Development problems.
  • Contractures.
  • Scoliosis.
  • Bone and joint defects.
  • Dislocated hip
  • Intestinal and bladder disorders.
  • Hydrocephalus.
  • Difficulty swallowing and breathing.
  • Meningitis.
  • Sleep apnea.
  • Skin conditions.
  • Urinary tract infections.
  • Gastrointestinal disorders.
  • Learning difficulties.

Diagnosis and treatment

Spina bifida is usually detected by the mother’s blood tests and a fetal ultrasound that can identify signs of spina bifida, such as an open spine or particular features in the baby's brain. The treatment to be followed will depend on the seriousness of the anomaly, but it is likely that prenatal or fetal surgery will be required, which is performed before the 25th week of gestation, either through open surgery of the uterus to correct the baby's spinal cord or with a fetoscope to make it less invasive. After birth, surgery is recommended to prevent infection, improve symptoms of the condition by repairing or closing the injury, and treat hydrocephalus, orthopedic conditions, or bowel and bladder problems. At the Pediatrics Center, we provide specialized care to our small patients from birth to adulthood, through our pediatric, oncology, neurology, and cardiology services at the level of the best medical centers in the world.

Fuentes:

  • kidshealth.org
  • topdoctors.es
  • healthychildren.org
  • mayoclinic.org
  • stanfordchildrens.org
  • medigraphic.com
  • Treviño-Alanís MG, González-Cantú MN, Martínez-Menchaca HR, et al. Espina bífida oculta, defecto en la tercera vértebra torácica. Med Sur. 2013;20(2):124-126.
  • Martínez SPA, Martínez MSE, Ortega GMV, et al. Evolución clínica posterior a tratamiento de escoliosis congénita y múltiples malformaciones óseas: reporte de caso en un gemelo dicigótico. Rev Mex Ortop Ped. 2018;20(1):49-55.
  • Buitrago-Leal M, Molina-Giraldo S. Utilidad de la medición de la traslucencia intracraneal en el primer trimestre, más allá de la espina bífida. Ginecol Obstet Mex. 2014;82(04):236-245.
  • Ruiz-Osuna C, Ávila-Zamorano ML, Suárez-Ahedo C, et al. Asociación de hueso intercalar cervical y espina bífida oculta lumbar y sacra en un mismo paciente. Reporte de caso. Acta Ortop Mex. 2009;23(1):31-34.

						
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