Question

Spina Bifida Patients

Spina bifida is a birth defect in which the developing baby’s spinal cord fails to develop correctly and can range from mild to severe depending on the type of defect, size, location, and complications. Bowel and bladder problems are a common complication as the nerves going from the spinal cord to the brain do not work properly. This results in not being aware that the bladder is full or when a bowel movement is happening. What medical interventions are available to help treat this group of patients?

Answer 1

Spina bifida

It is a birth defect which is characterized by underdeveloped spinal cord. The condition may be mild to severe. Mild form of this condition is spina bifida occulta. More severe form of this condition is spina bifida meningocele which can become complicated if not treated at the right time. The most severe form of spina bifida is myelomeningocele where the baby is born with a gap in the vertebral column and a part of the spinal cord is pushed through the gap and is visible on the baby’s back.

Babies born with spina bifida can develop several complications like bowel and bladder dysfunction, frequent urinary tract infections, hydrocephalus, meningitis, paralysis of legs, etc.

Although there is no cure for this condition, the disease can be managed and complications can be prevented. Treatment procedures depend on the severity of the condition and complications related with it.   

Some medical interventions which are available to treat spina bifida patients include:

• Walking and ability aids

Since this condition may be accompanied by partial or complete paralysis, mobility may be restricted. Hence, devices like braces, crutches, wheelchairs, walkers, etc. might be helpful.

• Special equipment like commode chairs, standing frames, and bath chairs may also be required to manage proper functioning.
• Physical therapy

Physical therapy involves exercises which aids in strengthening of muscles.

• Bowel and bladder management

Routine examinations which include X-rays, blood tests, scans, ultrasounds, etc. can prevent several complications like organ failure and recurring infections. Apart from this, medications, suppositories, use of catheters, etc. are also helpful in managing bowel and bladder issues.

• Surgical procedure may be required to keep the meninges in the right position and close the vertebral opening. This reduces the risk of infection associated with exposed nerves and spinal cord.
• Hydrocephalus (excess build-up of cerebrospinal fluid (CSF) in the ventricles of brain) is a complication associated with this condition. Surgery needs to be performed in such cases. The procedure involves placing a ventricular shunt which helps to drain the excess fluid into the abdomen. This is usually done early after birth. Similarly, a less invasive procedure called endoscopic third ventriculostomy may also be performed to drain the CSF.
• Skin problems are also associated with spina bifida due to limited movement, weak muscles, etc. Skin breakdown must be prevented by keeping the pressure regions clean and dry, prevent developing sores and blisters, encourage mobility, etc.
• Nurses can help the family to cope with the condition, educate them about the disorder, and lend support for the patient and family members.

The patient must be encouraged to be self-sufficient as much as possible. A team of surgeons, physicians, physical therapists along with nurses can help spina bifida patients lead a normal life.