SPINA BIFIDA

Spina Bifida Introduction

If your child is diagnosed with spina bifida, it can be a scary situation. Spinal Dysraphism (also called spina bifida) refers to 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 five convenient DFW Metroplex locations in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX.

  What is Spina Bifida?

Spina bifida refers to 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 nerves 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.

Diagnosing Spina Bifida

In the moderate and severe forms, spina bifida diagnosis is clear due to the protrusions from the back. However, a mild condition may go undetected following birth. In some situations, infants have a hairy 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.

Treating Spina Bifida 

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 this condition 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 on the severity of this disorder.

Spina bifida is a congenital neural tube defect that occurs when the neural tube, which forms the baby’s spinal cord, fails to close properly during early embryonic development. The severity of this condition can vary widely, and treatment approaches aim to address the specific needs of each individual affected. A multidisciplinary team of healthcare professionals typically collaborates to provide comprehensive care. This article explores various aspects of the treatment of spina bifida, covering medical interventions, surgical procedures, and supportive therapies.

Medical Management: Medical management plays a crucial role in addressing the associated complications and promoting the overall well-being of individuals with spina bifida. Key components of medical treatment include:

Prevention of Infections:

• Individuals with spina bifida are more prone to urinary tract infections (UTIs) and skin infections. Prophylactic antibiotics, along with regular monitoring and prompt treatment of infections, are essential to prevent complications.

Management of Neurological Symptoms:

• Medications, such as antispasmodic drugs and nerve pain medications, may be prescribed to manage symptoms related to nerve damage.  This includes muscle spasms and neuropathic pain.

Orthopedic Care:

• Orthopedic issues are common in spina bifida, and interventions may include braces, orthopedic shoes, and physical therapy. These items address musculoskeletal challenges and improve mobility.

Surgical Interventions:

• Spina Bifida treatment includes surgery to correct spinal cord defects, manage associated complications, and improve overall function. Common surgical interventions include:

          Closure of the Spinal Defect:

• In the early days of life, infants with spina bifida often undergo surgery to close the opening in the spine. This procedure, known as closure of the neural tube defect, helps protect the exposed spinal cord and nerves.

          Hydrocephalus Management:

• Hydrocephalus, a common complication in spina bifida, may necessitate the placement of a ventriculoperitoneal (VP) shunt to redirect excess cerebrospinal fluid from the brain to the abdominal cavity, preventing pressure buildup.

          Orthopedic Surgeries:

• Orthopedic surgeries may be required to correct musculoskeletal deformities, such as scoliosis or joint contractures, to improve mobility and prevent further complications.

Supportive Therapies:

• In addition to medical and surgical interventions, supportive therapies play a crucial role in enhancing the quality of life. These therapies include:

         Physical Therapy:

• Physical therapy focuses on improving strength, coordination, and mobility. It helps individuals with spina bifida maximize their functional abilities and maintain optimal musculoskeletal health.

         Occupational Therapy:

• Occupational therapy addresses activities of daily living, fine motor skills, and adaptive strategies to promote independence and enhance life.

         Psychosocial Support:

• Coping with the challenges of spina bifida can be emotionally taxing. Psychosocial support, including counseling and support groups, can provide emotional support for individuals and their families.

Conclusion:

The treatment of spina bifida is a multifaceted and lifelong process that involves medical management, surgical interventions, and supportive therapies. With advances in medical science and a comprehensive, collaborative approach to care, individuals with spina bifida can lead fulfilling lives, maximizing their potential and independence. Early intervention and ongoing monitoring by a dedicated healthcare team — like the Medical City Children’s Orthopedics and Spine Specialties with offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX — are crucial for optimizing outcomes and addressing the evolving needs of those affected by spina bifida. We are accepting new patients and invite parents of a spina bifida child to call us for an appointment.

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Footnote:

Center for Disease Control and Prevention: Spina Bifida