Spina Bifida Treatment in Noida, Delhi Ncr, India

Overview

Spina bifida is a congenital condition that occurs when the spinal cord and vertebrae do not form correctly. The severity of spina bifida varies based on the type of defect, its size, location on the spine, and the presence of other complications. Early surgical intervention can sometimes address the condition, but it doesn’t always result in complete correction.

Types of Spina Bifida

Spina bifida can be categorized into three main types:

Spina Bifida Occulta:
The most common and least severe type, where one or more vertebrae are malformed. Often, individuals are unaware they have this condition until it is detected incidentally during imaging for unrelated issues.

Myelomeningocele:
The most severe form, characterized by an opening in the spine through which membranes and nerves protrude, forming a sac on the back. This exposes tissues and nerves, increasing the risk of severe infections, paralysis, incontinence, and other gastrointestinal problems.

Meningocele:
A rare type where a sac of spinal fluid protrudes through a gap in the spine. The spinal cord is not in the sac, and nerves are usually unharmed, resulting in milder functional issues, such as those affecting the intestines and bladder.

Causes of Spina Bifida

The exact cause of spina bifida is unknown, but several factors may increase the risk:

• Folate Deficiency: Lack of natural folic acid (vitamin B-9) is a significant risk factor. Folic acid is crucial for a developing baby’s health.
• Family History: A history of neural tube defects in the family increases the risk.
• Medications: Certain medications, such as anticonvulsants like valproic acid, may interfere with folate utilization, increasing risk.
• Diabetes: Poorly managed diabetes in the mother can increase the risk.
• Obesity: Maternal obesity before pregnancy is linked to higher risk.
• High Body Temperature: Hyperthermia during early pregnancy from fever or hot tub use can increase risk.

Symptoms of Spina Bifida

Symptoms vary depending on the severity and type but may include:

• Bladder and bowel problems
• Open spinal canal along multiple vertebrae
• Protrusion of membranes and spinal cord/nerves at birth, forming a visible sac

Diagnosis of Spina Bifida

Diagnosis typically involves several tests before the baby is born:

• MSAFP Test: Measures alpha-fetoprotein (AFP) in the mother’s blood. High levels can indicate neural tube defects.
• AFP Levels Test: A follow-up blood test if initial AFP levels are high to confirm findings.
• Additional Blood Tests: Combined with MSAFP to screen for other conditions, such as Down syndrome.
• Ultrasound: The most reliable method, conducted in the first and second trimesters to detect spina bifida and assess severity.
• Amniocentesis: Involves sampling amniotic fluid to detect genetic conditions and confirm spina bifida diagnosis if ultrasound results are positive.

Treatment of Spina Bifida

While severe spina bifida cannot be cured due to permanent nerve damage, treatment focuses on managing symptoms and complications:

• Surgery: To close the opening in the spine and prevent infections.
• Physical Therapy: Helps children develop movement skills.
• Adaptive Equipment: Braces, crutches, and wheelchairs aid mobility.
• Medical Care: Ongoing care, including surgery, physical therapy, and medication, to manage complications and improve quality of life.

Prevention of Spina Bifida

Preventive measures include:

• Folic Acid Supplementation: Women of reproductive age should take 400 mcg of folic acid daily to reduce the risk of spina bifida by up to 75%.
• Medication Management: Discuss all medications and supplements with a doctor.
• Body Temperature Control: Use acetaminophen for fever and avoid hot tubs and saunas.
• Manage Diabetes and Obesity: Control these conditions to reduce risk.

Outlook

The impact of spina bifida varies widely. Some individuals experience no significant effects, while others face mobility and learning challenges. With proper care, most children with spina bifida can lead active, fulfilling lives. Consult a doctor promptly to explore treatment options for a child with spina bifida.

Review

Reviewed by Dr. Himanshu Arora, Director – Neuro Surgery & Spine, on 04-July-2024.