Spina bifida develops during the first few weeks of pregnancy, often before a woman is aware that she is pregnant. Dr Meher Thej AIIMS says, Spina bifida occulta, meningocele, and myelomeningocele are the 3 types of spina bifida. Spina bifida occulta, also referred to as “hidden” or “closed” spina bifida and Myelomeningocele, also known as spina bifida “aperta”, or “open” spina bifida, or spina bifida cystica.
Spina bifida symptoms vary according to type and severity, as well as between individuals.
Spina Bifida Occulta: Because the spinal nerves are not involved, there are usually no signs or symptoms. However, signs such as a tuft of hair, a small dimple, or a birthmark can sometimes be seen on the newborn's skin above the spinal problem.
According to Dr Meher Tej AIIMS, Meningocele type of spina bifida symptoms include:
small swelling in the back
Fluid filled sac that is visible at birth
membranes pushing out through the opening in the vertebrae.
normal development of the spinal cord
Myelomeningocele symptoms are more severe and can include the following:
A swelling in the baby's middle or lower back which contains the membranes and spinal cord.
Bowel and bladder problems
Muscle weakness in the legs
Orthopedic problems, such as deformities in the spine, hips or feet
For the most part, the most likely explanation is that spina bifida is caused by a combination of genetics, nutritional deficiencies, and environmental factors. Your environment includes everything you come into contact with in your daily life, including where you work and live, what you eat and drink, and how you spend your time. Air pollution and cigarette smoke can also harm the unborn baby. Most people who have spina bifida do not have a family member with the disease. Some cases have been reported to run in families, but there is no clear indication that spina bifida is inherited.
There are three types of spina bifida by Dr. Meher Thej AIIMS:
Spina bifida occulta: Spina bifida is a mild form of the condition. Spina bifida is also known as "hidden" spina bifida. It has no opposite impacts and may go unnoticed until later in life. Typically, there is no opening in the back of the baby, only a gap in the spine. There is no injury to the spinal cord or nerves in this type.
Meningocele: In this rare type of spina bifida, a sac consisting of spinal fluid protrudes through a gap in the vertebra, causing a swelling in the back. In this type no nerves are affected, and the spinal cord is not seen in the fluid sac. Babies with meningocele may have some minor problems with functioning, problems affecting the bladder and bowels.
Myelomeningocele: The common and serious form of spina bifida. In which the spinal cord and surrounding nerves come out through open Vertebrae and exit through the back of the fetus. People with myelomeningocele have physical disabilities that limit from moderate to severe. These disabilities may include:
difficulty going to the bathroom
inability to move or feel their legs or feet
Treatment of spina bifida will be different for each person as symptoms and severity can vary, says Boorgula Meher Thej. In some cases, especially spina bifida occulta, no treatment may be needed. However, myelomeningocele and meningocele require surgery to put the exposed sack and nerves back in place. Some of it may even need to be removed. The surgeon will then close the opening above the vertebra. A shunt may be placed to avoid complications later in life. This surgery is done soon after the baby is born. In some cases, antenatal surgery is also done while the baby continues to be within the womb. You should discuss the benefits and risks of both types of surgery with your doctor.
Another important aspect is prevention, the parents of the child with Spina bifida are counseled to take folate and zinc supplementation at least 6 months before planning the next child. Studies have shown that supplementation by 4mg Folate before and during pregnancy, decreased chances of Neural tube defects in the subsequent pregnancy by 71%. Additionally drugs which are associated with fetal abnormalities need to be avoided.
About Dr Meher Thej AIIMS
Dr Meher Thej AIIMS is a Neurosurgeon. He trained at AIIMS, New Delhi. He has experience in Neuro Oncology, Skull-Based Vascular Neurosurgery, Pediatric Neurosurgery, Functional-Epileptic Surgery, Spine Surgery and Neurotrauma. Dr. Meher Tej AIIMS in life's mission is to build a successful neurosurgical career, serve the people and grow oneself by encompassing all aspects of neurosurgery.