Spina bifida

Question 1

What is spina bifida?

Answer 1

The failure of the spinal cord to close during development resulting in exposure to the intrauterine environment

Question 2

Within the uterus, what types of damage will the spinal cord experience due to its incomplete closure?

Answer 2

Physical damage due to hitting the uterine wall
Chemical damage due to exposure to amniotic fluid

Question 3

What does spina bifida increase risk of while the fetus is in the uterus?

What is this?

Answer 3

Hydrocephalus

Cerebrospinal fluid leaks out of the incomplete closure, resulting in the cerebellum herniating out the foramen magnum and occluding cerebral spinal fluid flow out of the skull. This results in increased pressure on the brain and increases risk of brain damage

Question 4

What signs and symptoms can spina bifida cause?

Answer 4

Apnea/breathing problems
Lower extremity paralysis
Bowel and bladder dysfunction
Spinal curvatures
Club feet
Tethered cord (Nerve tissue getting entangled with scar tissue)

Question 5

What are the 3 types of spina bifida?

Answer 5

Myelomeningocele (Most severe)
* Spinal cord and meninges protrude out from vertebrae

Meningocele
* Only meninges protruding out of vertebrae

Spina bifida occulta (Least severe)
* No protrusion or damage of meninges or spinal cord

Question 6

What are the risk factors for spina bifida?

Answer 6

Folate deficiency (Vitamin B9)
* And medications that impair folate metabolism

Obesity prior to pregnancy
Family History
Poorly controlled diabetes
Increased body temperature
* Sauna or spa
* Fever

Ethnicity (Hispanic ancestry of greater risk)

Question 7

How is spina bifida treated and managed?

Answer 7

Pre-natal or post-natal surgery to repair myelomeningocele
Urinary catheterisation
Wheelchairs or crutches for mobility