Ask the Osteopath: Spina Bifida

Spinabifida condition, Spine

Spina Bifida is a condition as an osteopath I have seen on both ends of the scale. I have had patients that have been severely affected including having to walk with aids and having to have his bladder removed as a result. I have also seen patients that have no symptoms and came to see me about something completely different. This blog post goes hand in hand with my nutrition post of Folic Acid. If you haven’t already read it, read it now.

What is Spina Bifida ?

Spina Bifida is a condition that affects the neural tube development in a baby’s spin. Your spinal vertebrae (the bones in your spine) have different parts including the body (the main part), discs (between the bones) as well as arches. The function of the vertebrae is to protect the spinal cord and canal that runs behind it. In spina bidifa the arch of the bones do not fully form and leave part of the spinal cord exposed and not fully protected. The exact cause of the condition is not know however there is strong link with the amount of folic acid that is circulating in the mothers blood in the first 12 weeks of pregnancy.

What are the symptoms?

Symptoms do vary and many patients ill be asymptomatic and have no symptoms at all. The amount of symptoms and severity depends on the degree of malformation and the spinal nerves that maybe affected.

* Hairy patch or birthmark at the bottom of your spine
* Visible sac at the bottom of your spine
* Paralysis – partial or complete
* Difficulty swallowing, chewing and breathing
* Stiffness of limbs
* Weakness in limbs
* Bowel and bladder problems
* Increased risk of infections such as meningitis
* Learning Difficulties

How is it diagnosed?

Spina Bifida is normally identified on prenatal scans or maternal serum alpha fetoprotein screening (MSAFP) at around 16-18 weeks. It can also be detected through amniocentesis however it will not tell you the severity of the condition. In very mild cases it may remain undetected till after birth or missed completely.

In more severe cases it can also affect the development of the spinal cord itself.

There are 4 type of spina Bifia:

Meningocele, myelomeningocele, closed neural tube and Spina bifida occulta.

Myelomeningocele is the most serious type and the bones around the spinal cord are developed the least which means that part of the spinal cord and the protective membrane covering it (meninges) to be outside of the spine in a little pouch. Therefore it is significantly at risk of damage and dramatically increases the risk of infections within the cord. Symptoms include weakness, paralysis, loss of sensation as well as problems with your bowel and bladder.

Myelingocele is less severe with only the protective membrane being exposed out of the spine. Often you can have surgery on your spine to add more protection to the spinal cord and you will need no further treatment. There is not normally any damage to the spinal cord in this type.

Spina bifida occulta is the most common type affecting around 10-20 % of the population and is often asymptomatic. It is where there is a small gap in the spine and is covered with skin. The gap isn’t big enough for any of the spinal cord to protrude out. Most patients with this type will be completely unaware they have it and may never cause them problems. Most people that find out they have it later on is due to being more susceptible to developing lower back pain after an increase in a demand to the area such as age or taking up a new

Closed Neural tube defeats can be very similar to occult in the sense that patients may not experience any symptoms from the condition. However some patients can experience partial paralysis sometimes accompanied with bladder or bowel symptoms. This type of Spina Bifida covers defeats and malformations with the spinal cord that affect the bone, fat and meninges.

What are the treatment options?

A large majority of patients may not need any treatment for spina bifida. However there are some surgical options available normally to treat the complications rather than the actual condition itself.

Surgery:

There is experimental fetal surgery available to try to prevent the severity of the condition however it has signifiant risks.

The most common surgical option is associated with the myelomeningocele type to correct a complication causing tethering of the spinal cord where it gets stuck to a immovable object. This complication can cause significant symptoms such as weakness in the lower limbs as well as affecting bowel and bladder functions.

Due to the possible bowel and bladder complications including increase risk of infections there maybe an option to remove the bladder completely.

You can download this guide at on The A State of Health Clinic’s Website.

Sources:National Institute of Neurological Disorders and Stroke

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