spina bifida Flashcards
What is spina bifida?
A congenital disability where the neural tube fails to close in the 4th week post fertilisation which can cause paralysis and loss of sensation
Types of spina bifida
Closed: occulta
Open/cystica: meningocele, myelomeningocele
6 factors
Risk factors for spina bifida
Anticonvulsants in pregnancy
Maternal diabetes
Obesity in pregnancy
Possible genetic association
Low folic acid
Parental chemical exposure (Agent orange)
Spina bifida occulta
Mildest and most common form of spina bifida
Present in 10-20% healthy population
Incomplete formation of 1+ posterior arch of the vertebrae
Spinal cord and meninges remain in place
Covered by skin (± dimple/birth mark/hair)
Most commonly S1 (mainly lumbar sacral)
Does not usually cause any symptoms
Spina bifida meningocele
Protrusion of membrane through the spine
Vertebral arches unfused
Herniation of meninges
± covered by layer of skin
Spinal cord remains in vertebral canal
± symptoms, very varying severity
Spina bifida myelomeningocele
Most severe form, more common than meningocele
Protrusion of membrane and displacement of some or all of spinal cord through opening in spine
Partial or complete paralysis below level of spinal opening
Other problems in people with spina bifida
Bladder and bowel dysfunction
Learning difficulties (75%)
What level do lesions most commonly occur?
30% above T12, 70%
Higher level lesion more likely to impact cognitive function and spinal deformities
How often does spina bifida myelomeningocele disrupt CSF flow?
15-25% cases
Define hydrocephalus
Build up of CSF in brain or brain cavity
Causes increased pressure -> possible seizures and brain damage.
Shunts in hydrocephalus
80-90% of cases of hydrocephalus require a shunt
Shunt diverts CSF from around brain and spinal cord to another region where it can be absorbed.
Common impairments requiring orthotic intervention
talipes equinovarus, hip dislocation
