spina bifida

This condition falls into the class of what are referred to as neural tube defects, that is defects of early development of the neural tube structure of the embryo, which gives rise to the brain and spinal column. Spina bifida specifically refers to a condition in which a defect exists connecting the spinal canal with the outside skin. Instead of being totally enclosed in the protective bony spinal column, the spinal cord lies partially exposed to the outside world - creating an inevitable pathway for infection to enter the normally sterile fluids of the spinal cord and brain.

Certain nervous pathways to the lower body (anus, genitals, legs) are also either malformed or at jeopardy for damage by exposure or subsequent repair. Additionally, there may be hydrocephalus present which can damage the infants brain even prenatally. Luckily, the hydrocephalus is most often mainly caused as a result of closure of the lesion and is treated by a pressure relieving shunt at the time of initial corrective surgery.

While the gravity of the malformation is not to be dismissed, management of the defect has come light years. Prompt surgical closure of the defect followed by a specialised team approach to medical management has led to a good outlook for children with spinal cord abnormalities. If massive hydrocephalus is not present at birth, intelligence is often normal.

Parents need to be on the lookout for a congenital hairy patch or hairy birthmark at the base of the baby's spine. This could indicate a condition known as spina bifida occulta. In this condition, the defect exists deep in the spinal column and is hidden from direct appreciation. This hidden defect however is not benign. It can tether the spinal cord abnormally and over time cause progressive and irreversible damage to the spinal cord. All such birthmarks need careful evalutation, and very likely an MRI or CT scan should be done to rule out a tethered spinal cord.

The risk of occurrence of spina bifida and all neural tube defects can be dramatically lowered by the simple supplementation of the diet of all sexually active women of childbearing age with the B-vitamin folic acid.

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