Spina bifida is the most common birth defect of the central nervous system, in which the vertebral column and spine fail to develop properly while the baby is still forming in the womb. Four out of every 1000 children born in India have Spina bifida; though this condition can lead to serious debility, still there is a lot of prevailing unawareness about it. It is a complex condition with varying degrees of severity, and depending on the severity of disease, the symptoms and treatment options vary. However, irrespective of its type it can significantly impact the lives of those it affects.
Symptoms of Spina bifida
Spina bifida occurs in early pregnancy when the neural tube, a structure that eventually forms the brain and spinal cord, fails to close properly. As a result of this the spinal cord and nerves get exposed and affected leading to a range of physical and neurological complications in the affected individual. Though the symptoms of Spina bifida can vary greatly, some common symptoms include, mobility issues such as paralysis or weakness in the legs, bowel and bladder dysfunction, hydrocephalus, a condition in which excess cerebrospinal fluid accumulates in the brain, orthopedic problems such as scoliosis and foot deformities. With a wide range of symptoms affecting daily life, individuals affected with spina bifida and their families and caregivers, face many day-to-day challenges.
What is the cause of Spina bifida? The role of folic acid in prevention
The exact causes of spina bifida are not fully understood, but a combination of genetic and environmental factors is believed to play a role. Folic acid deficiency is an associated and preventable cause of this condition. Understanding the role of folic acid is one of the most significant breakthroughs in spina bifida prevention. Adequate folic acid intake before and during early pregnancy plays a pivotal role in preventing this neural tube defect. It helps in the development and closure of the neural tube in the fetus, thereby, reducing the risk of Spina bifida. Research has shown that women who get enough folic acid in the weeks before and after conception can reduce the risk of spina bifida and other neural tube defects by up to 70%. As a result, healthcare providers recommend that all women of childbearing age take a daily folic acid supplement of 400 micrograms and consume folate-rich foods such as dark green, and leafy vegetables, fresh fruits, and whole grains.
How is Spina bifida diagnosed and treated?
Spina bifida is often detected during pregnancy through routine prenatal screening. This early diagnosis allows parents and healthcare providers to prepare for the child's arrival and plan for early intervention, particularly in severe cases of Spina bifida.
Treatment for this condition is complex and typically involves a multidisciplinary healthcare team. Depending on the severity of disease, the treatment plan for Spina bifida may include:
Surgery: Surgical closure of the defect in baby’s back, during the initial days of life is essential to prevent infections and minimize nerve damage. Further surgeries may be needed as the child grows.
Shunt Placement: Hydrocephalus, a common complication in spina bifida, is treated with the placement of a shunt. This device helps drain excess cerebrospinal fluid from the brain.
Physical and Occupational Therapy: These therapies under the guidance of an expert can help improve muscle strength, mobility, and daily living skills of the individual affected with spina bifida.
Assistive Devices: Mobility aids like wheelchairs, braces, and orthotic devices may be required in the affected individuals.
Continence Care: Management of bladder and bowel dysfunction is crucial for maintaining quality of life.
Spina bifida is a lifelong condition that requires ongoing medical care and support. Early intervention services, such as physical therapy, occupational therapy, and educational support, are essential to address the individual's specific needs. It's important for individuals with spina bifida and their families, to work in close association with the healthcare team to manage their unique challenges and achieve the best possible quality of life.
Foundations that can bring doctors, therapists, affected families, and individuals with Spina bifida under the same roof can prove to be life-changing and build a strong community for support. Though Spina bifida is a challenging condition, with the right care and support, individuals affected by it can lead fulfilling and independent lives.
Spina bifida is a complex and challenging condition, but with advancements in medical care, early intervention, and the crucial role of folic acid in prevention, we can offer a better quality of life for those affected. By raising awareness about spina bifida, we can contribute to a future where fewer children are born with this condition, and those already living with it receive the right care and support.
Authorised by Dr. Khyati Kiran J, Consultant Paediatric Surgeon, Ankura Hospital
