What causes splitting of the spine( Spina bifida)

The modern world consists of people who can have minor deviations in health, not appearing in appearance, and can have serious malformations. Currently, medicine, faced with such problems, is trying to maximally solve these issues and create a more favorable development of events. Such a vice as the back of a bifid is no exception.

What is spina bifida? This is a rather rare developmental disorder that is associated with underdevelopment of the back parts of the spine and neural tube. Externally, this is manifested by the fact that through the defect of the bone occurs the bulging of the incompletely formed spinal cord , surrounded by a bag of its own membranes and thin skin.

Manifestations of each form

Spina bifida occulta( latent form)

It is characterized by the presence of an insignificant crevice in the arcs of the vertebrae, usually I of the lumbar spine, which does not cause the swelling of the spinal cord. With normal development of the nerves and spinal cord, the clinical picture will be poor, and this pathology can only be detected by X-ray examination. Sometimes the spinal cord can be attached until the last vertebra in the lumbar region, when physiologically it ends at the level of the first vertebrae of this department, freely sagging down. In this case, there may be mild abnormalities in the function of the pelvic organs: either the bladder or intestine, as well as persistent back pain or weakness in the muscles of the lower limbs. At birth, this developmental defect can be suspected by the presence of a spot or cavity at the site of an anomaly of the vertebrae.

Meningocele

Meningocele - this form is characterized by a moderate degree of severity, in which a large defect forms in the bones of the spine( often in the lumbar region).In this case, beyond its limits, the spinal cord envelopes, forming a bag filled with liquid. The walls of this formation are hard, arachnoid and soft shells. The spinal cord itself remains within the spinal canal, therefore, to solve this pathology, an operation is required to eliminate this defect and prevent damage to the nerves. The clinical picture with this form will consist of a disruption of the function of the pelvic organs, namely the bladder and intestine and moderate paresis of the lower extremities.

Myelomeningocele( spina bifida cystica)

The child has a photo of the Bifid's back of the heaviest form

The heaviest of the forms. When mentioning the diagnosis of the bifid spin, this form is immediately recalled, because it shows the real essence of this malformation. In this situation, the spinal canal is not completely closed and there is a swelling of not only the membranes of the spinal cord, but also itself along with the spinal roots. Outwardly, this hernial protrusion can be covered with an underdeveloped skin, or it may be like an "open book", protruding the tissue of the spinal cord with all the nerves.

The symptoms here will depend on the level of nerve pathway disorder. In "favorable" cases there is only a violation of the functions of the pelvic organs, in severe cases - paralysis of the lower extremities.

This form of the bifid back suggests several more developmental defects, namely:

• Chiari anomalies - the spinal cord moves upwards, the most infringement of the brainstem and the violation of speech and swallowing functions, as well as motor disorders in the upper limbs.
• Hydrocephalus - a violation of the outflow of cerebrospinal fluid from the brain. Requires surgical treatment: the application of shunts to remove excess fluid.
• Premature puberty, which is more common in girls in combination with hydrocephalus.
• Anomalies in the development of the urinary system.
• Malformations of the heart.
• Having problems with eyesight.

Diagnosis of bifid back

All women during pregnancy should undergo screening tests that will allow to suspect abnormal development of the fetus. These include:

• Blood test .During the 16-18 weeks of pregnancy, all women are tested for the concentration of rudimentary protein. It is produced by the fetus in a small amount, but in the presence of an open defect of the CNS or underdevelopment of the nervous system, the concentration of alpha-fetoprotein increases. There are some errors in the interpretation of the results, so several things should be carefully performed:

1. setting the exact period of pregnancy;
2. in time diagnosed multiple pregnancy.

• Prenatal ultrasound - the study is carried out at certain periods of pregnancy, in which pathology can be diagnosed. With this method, the brain and spinal cord and vertebral column are well visualized, as a result of which a timely diagnosis is guaranteed. With minor defects, namely a hidden form, pathology can be omitted.
• Amniocentesis - produce a puncture of amniotic fluid with a large needle under an ultrasonic sensor. To resort to this method it is possible only at detection in the analysis of a blood of the raised concentration of an alpha-fetoprotein, and on US any defects are absent. The liquid analyzes in the same way as the blood, so an increase in the embryonic protein indicates a splitting of the spinal column.
• Detecting the spine of the bifid at birth , as a rule, can be visually: the presence of a hernial protrusion on the spine, or a bag filled with the spinal cord and nerves, or spots( cavities) on one of the back areas. With spina bifida latent form, no external signs can be observed, but with the development of the child one can see the weakness and inferiority of the functions of the lower limbs, which gives the right to suspect this defect.
• The final diagnosis of should be confirmed by additional studies( X-ray diagnosis, CT, MRI).

Causes of

pathology The development of the fetus proceeds every time according to the programmed mechanism, however, due to unfavorable factors, the correct path may malfunction and underdevelopment of the body systems is observed.

One hundred percent cause of bifida spine development is not clear, however, at present there are factors that can lead to an abnormal development of the neural tube.

• Folate deficiency .Vitamin B is necessary for the fetus in the first months of development, because it is then that the nervous system is laid and differentiated. As a rule, the first three months before pregnancy and the next three months of pregnancy a woman needs to take folic acid, which helps to properly differentiate the nervous tissue.
• Family history of neural tube defects .In a family that already has a child with a vertebral column defect, the risk of having a second child with such a developmental defect increases with a 10% probability. In the presence of two children - this percentage is significantly increased.
• Medications. Admission of a woman during pregnancy anti-allopathic remedies that prevent the development of a defect in the spinal column, cause damage to the violation of the use of folic acid for the development of nervous tissue.
• Diabetes mellitus .There is a high risk of developing bifida spine if the mother has diabetes mellitus with high glucose values ​​in the first trimester of pregnancy. Therefore, its concentration should be regulated.
• Obesity .If a woman has obesity before pregnancy, then during her, there is a risk of developing a neural tube defect.
• Ethnic origin.

Treatment of the disease and subsequent rehabilitation

When exhibiting such a serious diagnosis, it is necessary to start taking immediate measures to eliminate the blemish. If this defect was diagnosed during pregnancy, then resort to prenatal surgery( currently the technique has not found wide application), which helps to close the defect of the vertebral column of small sizes.

Read an article on the pathology of the spine. Kimmerle's anomaly.

Than can be useful orthopedic corset for the back read here.

The delivery for this malformation is performed by caesarean section to prevent damage to the spinal cord as a result of passing the fetus through the birth canal.

At the birth of a child with a meningo- or myelomeningocele it is required to perform an operation to eliminate the defect in the first 24 hours. Emergency treatment prevents even more damage to the spinal cord and the development of complications.

Follow-up treatment includes rehabilitation: medical gymnastics, physiotherapy and wearing a corset.

Video: What is the essence of intrauterine correction of Bifid's back

Prevention of

In order not to develop the bifidus spin in children it is necessary to perform several stages:

1. Pregnancy planning - before conception of the child, it is necessary to completely examine various diseases, if any, they must be eliminated.
2. Prenatal diagnosis - monthly consultations with an obstetrician-gynecologist, pass the necessary set of examinations.
3. Admission of folic acid for 3 months before pregnancy and the first 3 months of pregnancy.