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SPINA BIFIDA- PATIENT INFORMATION
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:

  1. Maternal serum Alfa Fetoprotein (ms AFP)
  2. 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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