Spina bifida; means split or open spine. It is a congenital anomaly. It is seen at a rate of about 3 in 1000 in our country.
How Does Spina Bifida Occur?
It occurs with herniation of the spinal cord tissue (meningomyelocele) together with the membranes surrounding the spinal cord (meningocele) or membranes from the open area as a result of the failure of the spine (spine bones protecting the spinal cord) to close while the baby is in the mother’s womb.
There are 3 types of Spina bifida, which is most commonly seen in the lumbar region:
Spina Bifida Occulta: It is the mildest form of spina bifida. There are small defects or defects in one or more of the bones that make up the spine. The spinal cord and nerves are normal. It does not give any symptoms other than excessive hair growth on the skin in the area of the defect.
Meningocele: It is the rarest form of spina bifida. From the open parts of the spine, the membranes surrounding the spinal cord herniate outward. There is also cerebrospinal fluid that surrounds and protects the brain and spinal cord in the hernia sac.
Meningomyelocele: It is the most advanced and most severe form of spina bifida. The herniated sac contains the spinal cord and nerve roots along with the membranes.
What Should Be Done for Diagnostic Purposes in a Baby with Spina Bifida?
In the baby born with spina bifida, first of all, physical and neurological examination is performed. The type, weight, and degree of nerve involvement of spina bifida are evaluated by direct spine film, head and spinal cord ultrasound, computerized brain tomography, and magnetic resonance imaging.
How Is Spina Bifida Treated?
Spina Bifida occulta usually does not require treatment. In cases of meningocele where the spinal cord is not affected, surgical treatment is possible without any risk of paralysis. Many children with meningocele can continue their normal lives after surgical treatment.
A baby with meningomyelocele should be operated 24-48 hours after birth. Here, after the spinal cord is placed in place, it is covered with muscle and membrane layers. The aim is to prevent infection and to prevent nerve damage. However, if the nerves are already damaged before the operation, this is an irreversible event and leg paralysis and urinary and stool problems become permanent. These infants require long-term rehabilitation.
In babies with hydrocephalus, the accumulated fluid is drained without harming the baby with the help of a surgically placed shunt. In recent years, a new surgical method called “third ventriculostomy” has been used instead of shunt. It is a more natural method without complications caused by shunts.
