Split spine

Causes and remedy
Spina bifida means split spine in Latin.

It is a developmental birth defect caused by incomplete closing of the embryonic neural tube. Some vertebrae overlaying the spinal cord are fully formed and remain open.

If the opening is large enough, a portion of the spinal cord protrudes through the opening. There may be a fluid filled sac surrounding the spinal cord. Spina bifida occurs in 1-2 per 1,000 births worldwide.

Main categories

• Spina bifida occulta.
• Spina bifida cystic (Myelomeningocoele)

The commonest location of the malformation is lumbar/sacral spine (lower back).

Spina Bifida Occulta
Occulta means hidden.This is the mildest form of spina bifida. The split of the vertebrae is so small that the spinal cord does not protrude. The skin overlying the spin bifida occulta may be normal, have a tuft of hair, dimple, birthmark or a sinus. Many people with this mild form do not even know they have it as it has no symptoms.

Spina Bifida Cystica
This is when the defect in the vertebrae is large enough to allow the covering of the cord and the cord itself to protrude through the defect. The protruding portion of the cord and nerves, which originate at the level of the cord, are damaged and as a result, there is some degree of paralysis and loss of sensation below the level of the spinal cord default.

The exposure of the spinal cord makes the baby prone to life threatening infections like Meningitis. Many individuals with spina bifida have associated hydrocephalus (excessive accumulation of fluid within the brain ventricles).

Signs And Symptoms

• Hydrocephalus – head of infant appear large.
• Paralysis of lower limbs.
• Urine/stool incontinence.

Prevention
There is no single cause of spina bifida or any known way to prevent it entirely. However, a dietary supplement with folic acid is helpful in reducing spina bifida.

Pregnancy Screening
Defects of the spinal cord can be detected in pregnancy by ultrasound or by special tests on the amniotic fluid.

Treatment

• There is no known cure of nerve damage due to spina bifida. However, to prevent infection of the exposed spinal cord, surgery is done to cover the defect.
• A shunt is also inserted in the ventricle of the brain to drain the celebrospinal fluid into the abdomen.
• Care of the bladder and kidneys is important as they are prone to recurrent urinary tract infection.

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