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| SPINA BIFIDA- PATIENT INFORMATION
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How does this condition affect the child?
The
spinal cord normally carries messages between the brain and the
body and the limbs. These messages help to control movement of
the limbs. They also inform the brain about the feelings of touch,
pain and signals from bladder and bowel. In spina bifida, the
nerves are damaged because the spinal cord has not formed properly.
The amount of nerve damage varies greatly. The main effects are:
- Hydrocephalus
– excessive fluid in the brain.
- Muscle
weakness or paralysis:
Paralysis is below the level of spina bifida.
- Lack
of touch, pain sensation
- Bowel
and bladder incontinence.
- Leg
deformities –
Clubfoot, CTEV etc.
How is spina bifida diagnosed before birth?
Antenatally,
spina bifida is diagnosed by the following tests:
- Maternal
serum Alfa Fetoprotein (ms AFP)
- Antenatal
Ultrasonography:
Ultrasound
evaluation for spina bifida includes both spinal and cranial
imaging.
What is the treatment of spina bifida?
Back
closures are usually done earlier in the first 48 hrs in all newborns
unless there was contraindication like infection. Hydrocephalus
when present is treated V-P shunt. But the real task starts after
the initial management of the back closure and hydrocephalus.
How
are the other associated problems managed?
1. Management of Contractures
and deformities:
When
an infant with Spina Bifida is born, some joints or muscles in
the legs may be contracted or deformed. A contracture is a shortened
muscle, which prevents the full range of movement being carried
out at a joint. The joint may become stiff. A deformity is an
abnormal position of a joint. The joint may or may not move at
all. It is important to move each joint in the lower limbs
through full range of movement every day even if contracture and
deformities are not present. This will prevent the joints from
developing contractures.
Treatment
of contractures and deformities:
- Stretching:
If a full movement of joint is not possible. The child needs
daily stretching exercises.
- Positioning:
Positioning of the infant or child can assist in correction
and prevention of contracture and deformities. The child should
not remain in one position for long period of time.
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Last
updated on 30-10-2001
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