Spina Bifida

Spina Bfida is claimed to occur about once in every 1,000 births. It may even be less. Spina Bifida is a developmental abnormality, the spinal canal failing to completely close over. Various types are possible, but those occurring in the lower part of the back are more common.

Spina Bifida Symptoms

There may be a lump along the course of the spinal column, for example at the lower end. Symptoms may be mild or nonexistent, especially in the form referred to as spina bifida occulta. There may be a weakness of the lower limbs, and later, paralysis may set in; there may be a lack of control over the valves of the bladder and bowels. The parent may be first made aware of it when the child has difficulty in normal toilet training

Spina Bifida Treatment

Many mild cases may live a reasonably normal life. I treated a patient for many years, and he lived until his mid-50s before he died of sudden renal complications. He held down a normal, responsible job, and coped remarkably well. He married, and one lad was born who was perfectly normal.

Often if the disorder is picked up early, say at birth, when obvious cases may be quite apparent, surgery is attempted. A great deal is possible at the time, but unfortunately these children, although saved from death at the time, may endure a very difficult time afterwards and pose a major problem for those undertaking their care from that time on.

All patients will be cared for in accordance with their symptoms and their own level of attainment. Some may require intensive hospital care for a long period of time; other milder ones, such as my patient, may live for many years and engage in useful work.

It is possible to diagnose some of these cases antenatally now? Yes, with the so-called AFP (short for alpha-feto-protein) assessments, cases may be diagnosed before birth. This chemical is produced by the open nerve canal, and may be present in the amniotic fluid of the uterus, or increased amounts may be present in the mother’s blood.

In women who have sustained one case, there appears to be an increased risk of further babies with the same disability, and these women may be screened. It is an indication for a legal termination if the mother so desires it but this of course is an emotive and individual topic.