Spina bifida, also known as neural tube defect, is one of the congenital diseases that can be defined as a split or open spinal cord.
What is Spina Bifida?
The spinal cord transmits signals from the brain to the muscles. Allows the fulfillment of bodily functions. The disease, which means that the spinal bones of the baby in the mother's womb do not close in a healthy way, is a kind of developmental disorder.
This discomfort, which occurs in the first month of pregnancy, does not occur afterwards. In the presence of spina bifida, which is also known as lumbar opening in some sources, the spinal cord cannot fully perform its task. Depending on the defect in the spinal cord, some organs cannot perform their functions properly. In the presence of spina bifida, the spinal cord is not completely closed by the spinal canal, and the skin covering the spinal canal may not be fully closed.
In other words, the spinal cord may be outside the body. If the baby is born with spina bifida, the communication between the brain and the nerves may not be carried out in a healthy way. This leads to various degrees of paralysis, such as loss of sensation and limitation of movement. Depending on the location of the opening in the back, the state of limitation varies. The higher the opening in the back of the body, the higher the rate of being affected by the disease. That's why some people born with spina bifida can walk, while others can't even hold their stool and urine. "What is spina bifida?" It is necessary to answer the question. Also known as open spine or open spinal cord. Babies who continue to develop in the mother's womb do not have a closed spine during the embryonic period. In other words, the fusion of the spine to the midline occurs on the 29th day following fertilization. The spine, which continues its development by the fusion of the vertebrae on both sides of the body on the midline, does not close at all in the presence of spina bifida, or the closure is not fully realized in some regions.
This disease, which mostly occurs without realizing that the expectant mother is pregnant, is the most common conjunctivitis. It is one of the enital diseases. Spina bifida, which affects the musculoskeletal and genitourinary system, has a prevalence of 1 to 2 per thousand in the population. The spinal cord, which can be defined as a tube consisting of nerves in general terms, provides the transmission of requests from the brain to different parts of the body. This structure, which enables the muscles to move and the person to feel, cannot function in a healthy way in the presence of spina bifida.
In some types of the disease, in which the spine surrounding the spinal cord and the skin that covers it do not close, the baby is born with an opening in his back. This situation, which creates problems in the transmission of signals from the brain, leads to paralysis of different degrees in the person. The severity of the person's limitation varies according to the region of the opening in the back. The closer the opening in the spine is to the head area, the greater the limitation in the person. However, the incidence of the defect is higher in the lumbar region. There are different types of Spina Bifida disease.
What are the Types of Spina Bifida?
There are two main types and different subtypes of spina bifida. The most common ones are listed as spina bifida occulta, meningocele, and meningomyelocele. Also known as bifida. Often, even the person himself is unaware of the disease. A very small part of the bones in the spine are open in the disease that is noticed in the x-ray film taken for a different ailment or during routine health checks. In the presence of this condition, which cannot be noticed from the outside because it is covered with skin, a birthmark, dermal pit or hair clump can be seen on the back of the person. It does not cause limitation or a different health problem in the person.
The disease, which does not require surgery in this respect, may cause compression or stretching of the spinal cord in very rare cases. This condition, which can also be defined as tethered cord (tethered cord) syndrome, may prevent the nervous system from functioning properly and cause weakness in leg movements. , meningocele and myelomeningo Meningocele: The membrane structures surrounding the spinal cord, called the meninges, hang outward between the open vertebral bones. There is no spinal cord in this structure, which can be seen from the outside of the body in the form of a fluid-filled sac and is covered with skin. As a result, nerve damage is less. However, different complications may develop in the future.
- Myelomeningocele: Myelomeningocele, the most severe form of spina bifida, is more common than meningocele. Also known as open spina bifida, the spinal canal is open along several vertebrae located above the waist. The sac along the opening contains the spinal cord and nerves. Exposure of tissues and nerves outside the body may cause the baby to easily catch infections and pose a life-threatening risk.
What Causes Spina Bifida?
The cause of spina bifida disease Although it is not yet fully understood, it is thought that the combination of genetic and environmental factors is effective in the formation of the disease. The disease, which is more common in those with a family history of neural tube defects and folate deficiency, can be partially prevented by the use of folic acid at the stage of pregnancy, about a month before fertilization occurs. Low levels of folic acid in the mother's body, which is thought to help close the neural tube, may cause the spinal tube not to close properly.
The use of drugs such as valproic acid, which is used in the treatment of epilepsy, just before and during pregnancy may also play a role in the formation of spina bifida by causing a decrease in the amount of folate and folic acid in the body. Couples with a family history of neural tube defects are more likely to have a child with the same defect than healthy individuals. Uncontrolled blood sugar during pregnancy and obesity can also lead to some neural tube defects, including spina bifida. The presence of the listed factors does not necessarily mean that the baby will have spina bifida.
Can Spina Bifida Be Prevented?
Since the causes of Spina Bifida are not yet fully understood, the methods that can be applied to prevent the disease can only reduce the risk of developing the disease. Use of folic acid at the planned stage of pregnancy It is recommended to start the application. It is thought that folic acid, which is recommended to be started one month before pregnancy by physicians, reduces the formation of neural tube defects.
Unless the physician specifies a different dose, it is recommended to use 400 mcg (microgram) folic acid tablets daily during the period when the person intends to become pregnant. If the person has conceived unplanned, he should start using folic acid as soon as he learns that he is pregnant.
What are the Diagnosis and Treatment Methods for Spina Bifida?
Spina bifida, ultrasound examinations performed during prenatal checkups make a difference can be done. The presence of spina bifida can also be detected by amniocentesis. However, spina bifida is typically noticed just before or during birth.
People diagnosed with spina bifida are followed up and treated according to the type of disease. Fetal surgery, known as surgery in the womb, can be performed before the 26th week of pregnancy. Thus, the possible disability of the baby in the future can be reduced. Physiotherapy is extremely important for patients with spina bifida to be able to move independently after birth. By strengthening the leg muscles, the mobility of the person can be increased.
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