Three out of every thousand babies are born with spina bifida . It is a pathology in which the spinal cord of the fetus is exposed due to a poor or incomplete closure of the bony canal of the fetus’s spinal column. Thus, the nerve fibers that make up the spinal cord do not perform their function correctly, and they do not send or receive nerve signals well from the rest of the body.
Spina bifida can be located at any point in the spine, with the lumbar and sacral areas having the highest incidence. It mainly affects the motor capacity of children, and the degree of affectation will depend on the height at which the spinal cord is damaged, from loss of flexibility of the fingers to hemiplegia in more severe cases. In any case, the sequelae and diseases that are associated with spina bifida can be treated, but never completely cured.
WHAT IS SPINA BIFIDA
The spinal cord is responsible for transmitting nerve impulses and their response to muscles and organs. Being born with spina bifida supposes an abnormal development of the spinal cord, thus causing different types of injuries in the nervous system (therefore, in the rest of the body). In severe cases, the spinal cord sticks out of the baby’s back. This damage is irreversible and permanent, although the sequelae can be treated and control over the pathology can be achieved, it is not completely cured.
EARLY STIMULATION IS KEY TO THE DEVELOPMENT OF PEOPLE WITH SPINA BIFIDA
WHAT TYPES ARE THERE?
Not all cases of this disease are the same, and its importance will depend on where the injury is located. Three types are broadly described:
– Myelomeningocele: in these cases the child has what could be described as a pouch that appears in the spine and contains the nerves of the spinal cord. In some cases, there is no such bag, and the nerves can be seen. These babies have paralysis of the legs and problems controlling the bladder and bowels. It is one of the most serious cases.
– Meningocele: in these cases the bag, already mentioned, contains the membranes but not the spinal nerves. In this case, a surgical removal is performed. Is the less frequent case.
– Spina bifida occult: it is the mildest case. It consists of the existence of a small opening in some vertebrae of the spine. Sometimes it is detected when the child has grown and through an X-ray. It usually does not require treatment and does not usually cause symptoms.
CAUSES AND PREVENTION OF SPINA BIFIDA
The specific cause of spina bifida is unknown, as there are multiple factors involved in its appearance. One of the main causes that have been discovered is related to an insufficient level of folic acid in the maternal organism, a vitamin contained in some foods such as green leafy vegetables, legumes and oranges, and which intervenes directly in the formation of the nervous system before birth.
It is due to this direct relationship with the levels of folic acid in the body, that mothers are advised to take a vitamin preparation, rich in folic acid, one month before becoming pregnant or at the moment they discover that they are pregnant. It has proven to be a very simple and effective prevention measure since it manages to prevent 78% of the fetus from suffering from spina bifida.
Other causes that are related to this pathology are women with poorly controlled diabetes or who have ingested anticonvulsant medications during pregnancy. However, this problem is usually the result of a combination of genetic factors and environmental factors.
This malformation usually occurs in families who do not have a history. However, the couple who has given birth to a baby with spina bifida, the risk of it occurring in their next child increases by 4%. Therefore, it is recommended to see a doctor as soon as possible, in case of a new pregnancy, or even before becoming pregnant again.
WHICH IS THE TREATMENT?
There is no definitive curative treatment for spina bifida. The main objective is to prevent infections and preserve the cord and its nerves from external aggressions that can further damage it.
The first step in children with this disease is usually the surgical correction of the injury whenever possible. The objective of the surgery is not to correct the neurological deficit, since as we have already mentioned it is irreparable damage, but it will help to improve the child’s quality of life and prevent any other trauma that the exposed spinal cord may suffer.
Subsequent therapeutic stockings will depend on the degree and type of spina bifida, the age of the child, and the tolerance before specific stockings, procedures, and therapies. Some cares:
– Early stimulation , with activities to exercise your legs and feet and prepare you for the use of prostheses or crutches, if you need them.
– Stimulation of the extremities with massages and passive mobilizations of the joints. These mobilizations will help to maintain flexibility avoiding tendon shortening and will improve circulation.
– Special care for urinary incontinence and your intestinal problems. Many children need training in incontinence control. Some require a catheter that is inserted through the lower end of the urethra into the bladder, to allow urine to not collect.
– Stimulate activity and mobility for age-appropriate growth and development.
– It is common for them to develop an allergy to latex , it is important for these children to avoid contact with pacifiers, nipples and toys that contain this material.
As it is a disease that cannot be cured, the activities will aim to minimize deformities and maximize the child’s abilities to promote autonomy. It must be borne in mind that the complexity of the problem is not limited to after birth but progresses as the child grows.
CAN THE BABY HAVE A NORMAL LIFE?
Not long ago, children born with spina bifida died shortly after birth. Thanks to medical advances, today almost 90% of those affected survive. With early detection, medical care, and proper treatment, the future for these children is very bright .
In these patients, medical care and continuous treatment make a difference, and they can lead a normal life. Basically, the therapy consists of helping them reach the maximum development that their neurological deficit allows. However, the physical disabilities derived from the pathology can affect the social and emotional development of the child. To help them, experts recommend promoting independence in children, always taking into account their limitations and safety. We must, from a young age, teach them to participate in any activity with other children, and teach them to be responsible with their own care.