Spina Bifida Flashcards
Etiology of Spina Bifida
Congenital neural tube defect
Overall incidence is declining
Risk factors of Spina Bifida
heredity
environmental
teratogenic
folic acid
Folic Acid Deficiency
B vitamin
important for the production of red blood cels and neural tube formation
3-4 weeks of pregnancy
Teratogenic
Occupational hazards
folic acid deficiency
exposure to: vitamin a, solvents, lead, herbicides, alcohol
Visual Diagnosis
sac/cyst on the posterior aspect of the spine
Radiographic diagnosis
confirms vertebral bony non-closure
In-utero Diagnosis
2nd trimester ultrasound
High serum AFP (alpha-fetoprotein) - down syndrome
Fetal MRI
Four types of spina bifida
occulta, meningocele, myelomeningocele, myelocele
Occulta
mild presentation
opening in one or more vertebrae without apparent damage to spinal cord
results in only boney defect with spinal cord, meninges and spinal fluid intact
hair in spot on back
Meningocele
protrusion of meninges
repaired with little to no damage to nerves and pathways
involves the bifid vertebra, with only CSF filled sac protruding
least common form
Myelomeningocele
protrusion of meninges and spinal cord
most severe surviving form
spine is open and protruding sac contains: CSF, meninges, spinal cord or cauda equina
Myelocele
meninges are open
spinal cord is exposed: lack of neural tube formation
most severe
low survival rate
what % of spina bifida cases are lumbosacral
90%
Motor dysfunction
not symmetrical
muscle imbalance
contractures
scoliosis
Allergic reactions
68% of spina bifida have latex sensitivity
