About 1,600 to 2,000 babies are born with spina bifida every year in the United States. Apart from that, an estimated 166,00 adults and children have spina bifida. Spina bifida is a congenital disability that can cause physical and intellectual disabilities to anyone born with it. It's recommended to learn more about Spina bifida to accurately diagnose it during pregnancy, know its causes, and how it's treated. If you seek Spina Bifida treatment in Las Vegas, Nevada, schedule an appointment with Suarez Physical Therapy for a detailed insight on spina bifida and treatment for related complications.
Overview of Spina Bifida
Spina bifida is a congenital disability that involves the spine. It results from the improper forming of the baby’s spine and spinal cord during pregnancy. It usually occurs in the first month of the mother's pregnancy. When the neural tube doesn't close, the spine's bones that protect it don't form as they should. You can have spina bifida anywhere along the spine and often lead to damage of the spinal cord.
Types of Spina Bifida
Spina bifida is also referred to as a neural tube defect. Cases vary from mild to acute and fall under the three types of spina bifida: meningocele, myelomeningocele, and spina bifida occulta. Let's have a closer look at these types of spina bifida.
Most people with spina bifida have myelomeningocele, and it is the most severe of all. It causes most disabilities associated with spina bifida. It usually occurs after a sac opens through the baby's back containing the meninges, spinal fluid, and the spinal cord. Doctors can see this type of spina bifida on the baby's back and cause problems with movement, loss of feeling in the feet, legs, and problems with the urinary system.
Meningocele occurs when the sac occurs at the baby's back but doesn’t include the spinal cord but affects only the fluid. There is usually little or no nerve damage. This type of spina bifida can cause some minor disabilities.
Spina Bifida Occulta
Spina bifida occulta occurs when a baby's backbone doesn't form completely, leading to a small gap. This is not a common type of spina bifida and usually affects about one person in 10. It also doesn't have many disabilities and health problems associated with it.
Symptoms of Spina Bifida
The symptoms of spina bifida vary depending on the specific type that you are suffering from. The following is a detailed view of the symptoms of spina bifida.
Symptoms for Myelomeningocele
The symptoms of myelomeningocele include:
An opening in the spinal cord, especially in the middle and lower part of your back.
Exposed or appearance of a skin-covered sack of the spinal cord and membranes.
Scoliosis or curved spine.
Paralysis or weakness of the leg muscles.
Developing issues with the bladder or bowel.
Symptoms of Meningocele
Children with meningocele portray the following symptoms:
Having a small sac at their back, that’s visible during birth.
Presence of a small opening in their back.
Pushing out of the membranes through an opening in the vertebrae.
Symptoms of Spina Bifida Occulta
Children with spina bifida occulta portray the following symptoms:
Lack of fluid-filled sac outside their body.
Presence of a gap between the vertebrae.
Presence of a small dimple or birthmark on the child’s back.
Presence of extra fat on the child’s back.
Diagnosis of Spina Bifida
Spina bifida is diagnosed during pregnancy through Maternal serum alpha-fetoprotein test or AFP test, amniocentesis, and an ultrasound. Diagnosis can occur at the 16 to 18th week of pregnancy. For children with a small spinal opening, the condition is not diagnosed until the child's birth. Here is a closer view of the different spina bifida diagnosis methods.
AFP blood Test
An AFP test helps the doctor determine whether there are high levels of AFP. A high AFP might signify a miscalculation of the fetus's age and direct doctors to perform further tests to detect or rule-out the possibility of spina bifida defection. Therefore, your doctor must do a follow-up test to confirm whether your baby has spina bifida accurately.
Ultrasounds are the most accurate means of diagnosing spina bifida in a baby before delivery. Doctors can do an ultrasound in the first trimester (11 to 14 weeks) and the second trimester (8 to 22 weeks). The second-trimester ultrasound scan is the most accurate.
Advanced ultrasound can detect some signs of spina bifida, like particular features in the baby's brain that indicate possible spina bifida or an open spine. It can also detect the severity of the condition when handled by an expert.
When a prenatal ultrasound detects the possibility of spina bifida, your doctor might request an amniocentesis. In this test, the doctor will use a needle to remove a sample of the amniotic fluid from the amniotic sac.
An examination can help rule out any genetic disease, despite spina bifida being rarely associated with genetic diseases. Amniocentesis can cause pregnancy loss, which is a matter that pregnant mothers should discuss with their doctor before it's performed.
Causes of Spina Bifida
There are no specific known causes of spina bifida. However, scientists hold that it might result from several factors like family history, environmental factors, and a lack of folic acid in the mother's body and diet. In most cases, people hailing from a family with a history of spina bifida are at the highest risk of this congenital disability.
Risk Factors Associated with Spina Bifida
Studies have shown that spina bifida is a more common disease among Hispanics and whites. They have also shown that it affects females more than males. Even though researchers and doctors aren't sure of why spina bifida presents itself, but have identified the following risks:
Folate is crucial in the development of a healthy baby. It’s the natural form of Vitamin B-9, and its synthetic form includes fortified foods and supplements. Lack of folate increases the chances of spina bifida.
A Family with a History of Spina Bifida
Couples with one child with spina bifida have fewer chances of spina bifida. There is an increased chance of risk if they have two children with the same condition. Apart from that, a woman born with spina bifida has a high chance of conceiving a child. This does not rule out that most children born with the defect are born from parents without spina bifida in their family history.
Studies have shown that some anti-seizure drugs like valproic acid may cause spina bifida when taken during pregnancy. These drugs can cause spina bifida since they interfere with a pregnant woman's ability to use folic acid.
Women with diabetes and poor control of their blood sugar have high chances of having a baby with this congenital defect.
There are chances of giving birth to a child with spina bifida if you have pre-pregnancy obesity.
Increase in Body Temperature
Most researchers have suggested that increased temperature, a condition referred to as hyperthermia during the early stages of pregnancy, increases the possibility of spina bifida. Elevation of your body temperature can result from severe fever, or occasional usage of a hot tub and sauna has been considered a possible cause of spina bifida.
Complications Associated with Spina Bifida
Spina bifida can cause mild disabilities and symptoms. However, severe spina bifida can cause severe physical disabilities. The severity of the disabilities depends on:
The location and size of the spina bifida
Whether there is skin covering the affected area
The type of spinal nerve that comes out of the area affected
Based on the above-stated factors, the following is a list of potential complications associated with this defect. However, you should note that not all children end up with these complications. Apart from that, some of these conditions are treatable. These complications are as follows:
Mobility and Walking Problems
Your child’s leg muscles’ nerves cannot work properly if he or she has spina bifida. This can lead to muscle weakness and paralysis. The possibility to walk depends on the type of care that a child receives.
Children with spina bifida end up with problems in their spine and legs. This results from weakness in their legs and back muscles. Problems associated with this complication rely on the defect's location. Some of the orthopedic issues include:
Bone and joint deformities
Bladder and Bowel Issues
Your child's bowel and bladder nerves cannot work well when a child has myelomeningocele since these nerves come from the spinal cord’s lowest position.
Babies born with spina bifida usually experience fluid accumulation in their brains. This condition is referred to as hydrocephalus.
Malfunctioning of the Shunt
The shunts placed in the brain to manage hydrocephalus can be infected or stop working due to spina bifida. There are different types of signs associated with this. Some of the signs indicating a non-functional shunt include:
Swelling or redness along the shunt
Some babies with spina bifida can develop meningitis, which is an infection of the tissue around the brain. Meningitis is a severe infection that can lead to a brain injury.
Both adults and children with spina bifida, especially myelomeningocele, may suffer from sleep apnea or other sleep disorders. Assessment of sleep disorder can help detect sleep-disordered breathing, which warrants appropriate treatment to improve the health and life of the affected person.
Tethered Spinal Cord
People with spina bifida can have a tethered spinal cord when their spinal nerves bind to a scar at the point where the spina bifida defect was surgically closed. The spinal cord grows as the child is growing, meaning that the scarring can take a long time to go away. As a result, there is a progressive tethering of the spinal nerves, leading to loss of bowel, bladder, and leg muscle function. Surgery can reduce the extent of disability.
There is a high possibility of children with this congenital defect to develop wounds on their buttocks, feet, and legs. Because of the loss of feeling that children with this diagnosis display, these wounds can progress from sores or blistered to exposing bone. The blisters and sores can turn into deep infected wounds that are difficult to manage. Minors with myelomeningocele are at the highest risk of this complication, thus, skin integrity should be closely monitored.
There is a high possibility of developing an allergy to latex in children with this defect. This means that they have an allergic reaction to latex products or natural rubber. Latex allergy causes rashes, sneezing, a runny nose, and watery eyes. Spina bifida latex allergies can also cause anaphylaxis, a severe condition characterized by the swelling of the airways and face, resulting in breathing difficulty. That's why doctors are advised to avoid wearing latex gloves when delivering a child with this defect.
Prevention of Spina Bifida
Although the cause of spina bifida is unclear, there is evidence suggesting that a woman can dramatically reduce the chances of giving birth to a child with this condition by getting enough folic acid.
Folic Acid Supplements
Most doctors strongly encourage pregnant women to take folic acid, to enable their bodies to produce healthy new cells. Folic acid is essential during pregnancy since it helps in making new cells that lead to the growth of the unborn child.
Folic acid is available in foods like spinach, oranges, beans, and peas. Doctors also recommend pregnant women take at least 400mg of folic acid every day for a minimum of three months before they plan to be pregnant. They should continue taking folic acid throughout their pregnancy.
Women from a family with a history of this defect are recommended to take a dose of 4,000mg of folic acid if they plan to become pregnant.
How a Physical Therapist Can Help in Managing Spina Bifida Related Complications
Physical therapy is essential in the management of complications associated with this congenital defect. Physical therapists can help adults and children to regain their functional mobility at different stages of their life. Physical therapy for spina bifida management involves several health care specialists like occupational therapists and orthopedists to address an individual's needs.
Physical therapists usually decide on a complications management structure based on a performance evaluation such as:
The Patient's Birth and Development History
Your physical therapist will inquire about your child's birth and development stages. They will ask about when your child held his head upright, crawled, sat up, rolled over, walked, and so on.
Common Health Questions
Your therapist might ask questions regarding your child's hospitalization, the last time when you visited a healthcare provider, and whether there are any health issues raised during these visits.
Your physical therapists will also raise questions about your concerns as a parent whose child has spina bifida. They ask about things like your worries and what you expect to accomplish through the therapy intervention.
Your physical therapist might also conduct physical examinations like measuring the child's height, weight and observing his movement patterns. They also conduct hands-on assessments of their muscle tone, flexibility, and strength, as well as, difficulties with functional mobility .
Motor Development Tests
Your physical therapist might also undertake specific tests to confirm your child's motor development, like standing up, walking, crawling, and sitting. They might also check the child's ability to use his hands, intellect, language skills, and other developmental areas.
Referring Your Child to Other Specialist
Finally, your physical therapist can refer your child to another specialist to guarantee a collective in addressing your child's needs.
Your physical therapist will gather enough information from the evaluation to develop a detailed complications management structure. The therapist will adopt a management program based on the severity, type, and area affected by the complication. Some of the treatment options that the therapist can adopt are as follows:
Mobility and Walking Aids: your therapist might decide to start exercising your baby to prepare his legs for walking using braces or crutches when they grow older. Some children might also need to use a wheelchair or walker. The use of mobility aids along with regular physical therapy can help your child become independent. Children using wheelchairs can also learn how to function well and become self-sufficient.
Bladder and Bowel Management: Your therapist will also encourage having routine bladder and bowel evaluations and management to reduce the chances of organ damages or illness. Their evaluation involves recommending different approaches like ultrasound, kidney scans, X-rays, and blood tests. These evaluations are frequent in the first years of your child's life and are reduced as he or she grows. It's recommendable to involve a pediatric urologist in this evaluation to perform surgery on the child when needed.
Hydrocephalus Surgery: Most children with hydrocephalus need a surgically placed tube or shunt that allows fluid inside the brain to drain into their brain ventricular. The therapist might recommend a less invasive procedure referred to as endoscopic third ventriculostomy, although candidates must meet certain criteria. During this procedure, the surgeon uses a small camera to see the brain and make a hole between the ventricles. The hole allows the cerebrospinal fluid to flow out.
Management and Treatment of Other Complications: Management of spina bifida complications can also involve special equipment like commode chairs, standing frames, and bath chairs. They help in daily functions that improve your child's quality of life.
Find an Experienced Physical Therapist Near Me
The ability to manage different types of complications associated with spina bifida depends on the physical therapist you choose. You need someone well-versed with these complications, accessible, and can engage different health professionals. At Suarez Physical Therapy, we guarantee a quality care.experience driven services to anyone seeking professional therapy services related to spina bifida complications in Las Vegas, Nevada. Our team of experts is ready to help you evaluate your needs and structure a detailed program that guarantees the best outcomes. Contact us today at 702-368-6778 and learn more about us.