SPINA BIFIDA

Spina Bifida Diagnosis and Treatment

If your child is diagnosed with spina bifida, it can be a scary situation. Spinal Dysraphism (also called spina bifida) is a condition in which a baby’s spine and spinal cord do not form properly during pregnancy. The spine and spinal cords are then exposed to the surrounding environment inside or outside the body. However, it’s important that parents understand they are not alone in handling this complex medical condition. The best news is that skilled pediatric orthopedic physicians like Dr. Kishan, Dr. Hostin, and Dr. Wiesman can provide effective treatments to help you manage the condition before and after surgical intervention and help you and your child face lifelong health considerations related to this developmental condition.

If you have questions or want to schedule a consultation for your child with our team, our physicians will take the time to walk you through the treatment options so that you can make a decision together.

Finally, we have four convenient DFW Metroplex locations in Arlington at Arlington Medical City Hospital in building A, in Dallas at Medical City Hospital in building C, in Frisco at Frisco Square, and in McKinney at McKinney Medical City Hospital. This ensures there’s a DFW area office near you where your child can receive comprehensive care.

What is Spina Bifida?

Spina bifida is a condition that affects the development of the backbones, spinal cord, nerves, and the fluid-filled sac that surrounds the spinal cord. Unfortunately, this advanced neurological condition may cause part of the spinal cord or surrounding structures to develop outside of the body instead of internally. Also, this disease can affect any portion of the spinal cord.

There are three main types of spina bifida:

• Occulta Spina Bifida – this is the mildest form of the condition, and it typically creates minimal if any visual changes on the exterior of the body. Instead, this form affects the development of the lower part of the back.
• Meningocele Spina Bifida  – this moderate form of the condition does have a fluid-filled sac on the exterior of the back, but no spinal cord or nerve tissue is housed within this sac.
• Myelomeningocele Spina Bifida  – this is the most severe form, and it causes the spinal cord and nerve to develop outside the body. This can lead to severe pain and difficulty moving lower limbs and controlling bowel and bladder function. The vast majority of infants who suffer from this form also experience hydrocephalus. This condition causes pressure to build up inside the skull, leading to larger than average head size.

How is Spina Bifida Diagnosed?

In the moderate and severe forms, spina bifida diagnosis is clear due to the protrusions from the back. However, the mild spina bifida occulta may go undetected following birth. In some situations, infants have a harry spot, mole, or other visual markers that indicate this condition. If the mother decides to undergo amniocentesis, others may receive a diagnosis prior to birth . This can reveal high levels of alpha-fetoprotein (AFP) that are often indicative of spina bifida. In some cases, you may also be able to see the changes to the spinal cord during an ultrasound. If none of these indicators of spina bifida occulta are present, your child’s case may go undiagnosed for a time until the difficulty with motor skills and other symptoms indicate a need for testing. Then, ultrasound, CT scans, and MRIs may be used to make an accurate diagnosis.

The advantage of being with Medical City Hospital is the focus on both adults and pediatrics. If, while pregnant, your OBGYN detects high levels of alpha-fetoprotein (AFP), your physician can immediately refer you to Medical City Children’s Orthopedic and Spine Specialists and set up a consultation with Doctors Kishan, Hostin or Wiesman to immediately discuss treatment options.

How is Spina Bifida Treated?

Like muscular dystrophy, spina bifida cannot be cured. However, with proper treatment and symptom management, your child can lead a long, healthy life. Moreover, treatment for spina bifida is largely dependent upon which of the three types your child is suffering from. There are both surgical and nonsurgical treatments that may be recommended depending upon the severity of this disorder.

Nonsurgical Treatments

Typically, non-surgical treatments are only beneficial for those patients with the two milder forms of spina bifida. These therapies may include:

• Physical therapy and rehabilitation
• Positioning aids
• Braces and splints
• Medications

Surgical Treatments

For the more severe forms of spina bifida, we may need to perform one or more surgical treatments, including:

• A procedure to return the interior aspects of the spine and close the lesion.
• If your child is suffering from skull enlargement (hydrocephalus) caused by a buildup of fluid inside the skull. We’ll need to perform a surgical intervention to relieve the pressure.
• Children who are having trouble controlling their bowels or bladder may also need to receive surgical intervention to improve function.
• Finally, as the infant begins to become more mobile, we may need to provide surgical intervention to allow the child to sit, stand, crawl, and walk without pain or difficulty.