Spina Bifida

Overview

Spina Bifida is a congenital condition where the spine and spinal cord do not develop properly during early pregnancy. This condition can cause varying levels of disability, from mild mobility difficulties to more complex neurological and physical challenges.

Types of Spina Bifida

There are different forms of Spina Bifida, including:

• Spina Bifida Occulta – The mildest form, often with no visible signs or symptoms
• Meningocele – A sac of fluid protrudes through the spine, but the spinal cord remains unaffected
• Myelomeningocele – The most severe form, where part of the spinal cord and nerves are exposed, causing significant physical and neurological symptoms

Causes of Spina Bifida

The exact cause of Spina Bifida is not always known, but several factors may increase the risk, including:

• Genetic predisposition, particularly if there is a family history of neural tube defects
• Folic acid (vitamin B9) deficiency, especially during the early stages of pregnancy
• Certain medications, such as sodium valproate or other anti-epileptic drugs, which can interfere with folic acid metabolism
• Environmental factors, including poorly controlled diabetes, obesity, or exposure to high heat (such as saunas or hot tubs) during early pregnancy

Taking folic acid supplements before conception and during the first 12 weeks of pregnancy significantly reduces the risk of Spina Bifida.

Symptoms of Spina Bifida

Symptoms vary depending on the type and severity of the condition:

Mild Cases (Spina Bifida Occulta):

• Often no symptoms or only subtle signs
• Small dimple, birthmark, or tuft of hair on the lower back

More Severe Cases (Myelomeningocele):

• Muscle weakness or paralysis in the legs
• Difficulty walking or mobility impairments
• Loss of bowel or bladder control
• Hydrocephalus (excess fluid on the brain)
• Spinal curvature (scoliosis)
• Learning difficulties or cognitive challenges

Diagnosis

Spina Bifida is often diagnosed during pregnancy through:

• Prenatal ultrasound scans
• Maternal blood tests measuring alpha-fetoprotein (AFP)
• Amniocentesis, in some cases

Postnatal diagnosis may involve:

• Physical examination
• MRI or CT scans to assess spinal and neurological involvement

Treatment & Rehabilitation

While there is no cure for Spina Bifida, treatment and rehabilitation can significantly improve quality of life:

• Surgical intervention, often carried out shortly after birth for severe cases
• Physiotherapy, to improve strength, balance, and mobility
• Occupational therapy, to promote independence in daily life
• Bladder and bowel management support
• Hydrotherapy for low-impact exercise
• Psychological support for patients and families
• Specialist mobility aids and orthotics, as required

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