Spina Bifida

Causes and how urination is affected

What is Spina Bifida?

Spina Bifida is the most common type of developmental defect that causes disabilities and is a health condition that is present at birth. Spina Bifida is a Latin term that literally means “split or open spine”.

Possible Causes of Spina Bifida

Children born with Spina Bifida have a serious birth abnormality in which there is an incomplete fusion of the vertebral arches in the lumbar region, meaning the skin covering the spinal cord does not close completely.  Many different variations of the condition are reported. 3,7,8

While there are many genetic and environmental influences that may contribute to the cause of Spina Bifida, they are not all completely known or identified.  Literature suggests that the following factors may play a role in the development of Spina Bifida:4,7,8

  • Ethnic group
  • Genes
  • Health conditions and medicines taken during pregnancy

Folic Acid

In 1992, the US Public Health Service recommended that all women of child-bearing age should consume 400mcg of folic acid daily to reduce the risk of having a pregnancy affected by neural tube defects like Spina Bifida.  Folic acid is a B vitamin that every cell in a person's body needs for normal growth and development.  The US Public Health Service also recommends that women who have Spina Bifida, have a child or pregnancy impacted by Spina Bifida, take 4000mcg (4.0 mg) of folic acid for one to three months before pregnancy.4,7,10

As a result of the determination, the U.S. Food and Drug Administration mandated adding folic acid to all enriched cereal grain products by January 1998.1,7  

Spina Bifida occurs worldwide, but there has been a downward trend in occurrence rates in the US since the US Food and Drug Administration mandate took effect. 7

According to the Centers for Disease Control, each year more than 1,500 babies are born in the United States with Spina Bifida.  In the US, Hispanic women have the highest rate of having a child affected by Spina Bifida compared with Non-Hispanic White and Non-Hispanic Black women.1,7,9, 10


Please note that the information provided by Liberator Medical in this article is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


How Spina Bifida May Affect Your Child

Spina Bifida can affect the way a child’s brain, spine, spinal cord form.4

The brain, spine, spinal cord and meninges form in the womb and function after birth. Meninges are the tissues that cover and protect the brain and the spinal cord.4,7

According to the literature, the most common types of Spina Bifida are:

  1. Myelomeningocele (also called open Spina Bifida). This is the most severe and the most common form of Spina Bifida. In this condition, part of the spinal cord pushes out with the meninges through the gap in the spine to form a sac on the baby’s back.  The spinal cord and nearby nerves are damaged.  This condition can cause paralysis (when one or more parts of your body cannot feel or move). An increase in infection rates and allergies as well as other diseases frequently occurring in conjunction with Spina Bifida have been reported.  Babies with this condition may need surgery before birth or within the first few days of life.  During surgery, a surgeon tucks the spinal cord and nerves back into the spine and cover them with muscle and skin.  This can help prevent new nerve damage and infection.  But the surgery can’t undo any damage that’s already happened.  Even with surgery, babies with this condition may have different forms and sometimes lasting disabilities, like problems walking and going to the bathroom. 3,4,7,8,9,10
  2. Spina Bifida Occulta (also called Hidden Spina Bifida).  This is the mildest form and usually doesn’t cause health problems.  In this condition, the gap in the spine is small.  The spinal cord and nerves stay in place and usually aren’t damaged.  A dimple or tuft of hair may appear on the overlying skin. 2,3,4,5,7,8,9,10
  3. Closed neural tube defect.  In this condition, the fat, bone or meninges around the spinal cord don’t form correctly.  This sometimes damages the nerves in the spinal cord.  This condition often causes no symptoms, but some babies may have problems controlling their bladder and bowels (going to the bathroom).4,10
  4. Meningocele.  This is the rarest form. In this condition, the meninges push out through the gap in the spine.  This creates a sac filled with fluid (called a meningocele) on the baby’s back.  There’s usually little or no nerve damage, but some babies may have problems controlling their bladder and bowels.  Surgery can be done to remove the meningocele. 4,7,9

The good news is that the CDC also reports “many adolescents and young adults with Spina Bifida report a high level of satisfaction with their health-related quality of life, are entering and succeeding at college life, and are participating in sports and other recreational activities.1 


Please note that the information provided by Liberator Medical in this article or on this website is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Neurogenic Bladder

Children with Spina Bifida often need to perform intermittent catheterization or take other medical steps to help empty their bladder.7,8

Using Intermittent Catheters - Children with Spina Bifida

Children with spina bifida often can’t control when they need to go to the bathroom because the nerves that control their bowel and bladder are damaged.  If a child has problems emptying their bladder completely, they can develop problems with urinary tract and kidney infections.4,8

Healthcare providers and parents agree that when it comes to continence care management, it is best for children and their caregivers’ for the child to become as independent and educated on intermittent catheter use as early as possible.7,8

Using a clean intermittent Catheterization (CIC) technique is a key part of hygiene for catheter use in children.  Additionally, many children born with spina bifida also have a latex [natural rubber] allergy, so it is important that children with SB who self-cath must use a type of intermittent catheter that is latex-free.4,7,8

With help, it is possible for children with SB to learn how self-catherize on their own.  Discretion is a key part of a daily continence care regimen, as most intermittent catheter users don’t want anyone to know about their catheter use.  However, privacy is especially important to children when it comes to their bathroom routines.5


Please note that the information provided by Liberator Medical in this article or on this website is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Resources and references for the article above

In the US, the Spina Bifida Association offers a variety of family-centered programs through their nationwide network of chapters and support groups.

Finding Additional Spina Bifida Support Resources

In the US, the Spina Bifida Association offers a variety of family-centered programs through their nationwide network of chapters and support groups. Spina Bifida Association chapters deliver public and professional education, information, and support on a community level.

Find One Near You

The Spina Bifida Association [www.spinabifidaassociation.org] also offers a wide variety of educational materials designed for both parents and children, and many of their health resources can assist with bowel and bladder programs. 

References:

  1. Centers for Disease Control and Prevention. (2010). Data and statistics. Available online at: https://www.cdc.gov/ncbddd/spinabifida/data.html
  2. GRAY’S Anatomy Review- First Edition. Gray's Anatomy Review (Kindle Locations 15-21). Elsevier Health Sciences. Kindle Edition.
  3. NIH: National Institute of Neurological Disorders and Stroke – website
    https://www.ninds.nih.gov/disorders/spina_bifida/spina_bifida.htm
  4. March of Dimes. (2009). Birth defects: Spina Bifida. Available online at: https://www.marchofdimes.com/baby/birthdefects_spinabifida.html
  5. Spina Bifida Association. (2008). Spina Bifida. Available online at: https://tinyurl.com/3qegx2y
  6. Spina Bifida Association –National Resource Center. Folic Acid. Available on-line https://www.spinabifidaassociation.org/atf/cf/%7B85F88192-26E1-421E-9E30-4C0EA744A7F0%7D/Folic%20Acid.pdf
  7. Ozek M, Cinalli G, Maixner W, The Spina Bifida Management and Outcomes, Springer Milan Berlin Heidelberg New York, 2008
  8. Rekate H MD, Comprehensive Management of Spina Bifida, CRC Press, Boca Raton, Ann Arbor, Boston, 2006
  9. Clinical Neuroanatomy 27th Edition, McGraw-Hill Education, 2013
  10. Agopian AJ, etal. Spinal Bifida Subtypes and Sub Phenotypes by Maternal Race, Ethnicity in the National Birth Defects Prevention Study, Am J Med Genet Part A 158A:109-115, 2011

 Information is as of 12/2014. Please check references for updated information.

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