What is Spina Bifida?
A congenital disorder, spinal bifida requires that the patient receive their treatment from a variety of sources. Spina bifida is a neural tube defect which affects patients throughout their entire lives. The neural tube, during development, is a structure in the embryo that eventually develops into the brain and spinal cord, as well as their enclosing tissues. The neural tube is supposed to close within 28 days of conception. If it does not close properly within the standard frame of time, spinal cord and backbone defects will occur.1 The term “spina bifida” means, literally, “open spine”.
One way that the patients’ parents can increase the chance of preventing 70% of the spina bifida cases is to take 400 mcg of folic acid every day, before they even become pregnant. This is the most effective method of decreasing the risk. Those women with a family history of the disorder, or those who have a history of prior pregnancy which resulted in this disorder, should consider higher doses of folic acid. The parent should consult with their caregiver about increasing their dosage.2 While it is suggested that there are some genes involved in the development of the congenital disorder, other possible causes include the onset of a high fever in the parent during pregnancy, or the parent’s use of the epileptic medication valproic acid.3
What Are the Forms and Effects That Spina Bifida Takes?
Spina bifida has two forms. Spina bifida occulta, which is the mildest form, means that the defect is “hidden” by skin. There may not be symptoms which present in the patient, and the spinal cord may not even be affected in the mild form of the disorder. Spina bifida manifesta can involve the meninges (“meningocele”), which protect the brain and spinal cord. The most severe spina bifida manifesta is called “myelomeningocele”. In this form, the meninges and spinal cord actually push through and protrude from a hole in the patient’s back. Most of these affected babies develop the presence of fluid around the brain, or hydrocephalus, as well. Paralysis, to some degree, is typically another result of this disorder. The higher on the patient’s back that the opening is located, the more severe the paralysis is likely to be.
Other complications of spina bifida include problems in relation to both the patient’s bladder and bowel control, attention deficit hyperactivity disorder (ADHD), hand-eye coordination problems, and learning difficulties.4 Additional issues resulting from spinal bifida may include pressure sores, abnormal eye movement, club foot, scoliosis, hip dislocation, leg weakness, brain abnormalities, poor cognitive flexibility, difficulty planning and organizing, and social troubles. Most children with spina bifida also develop latex allergies as a result of the disorder. This can make medical treatments more challenging due to the common presence of latex medical supplies such as catheters and gloves. There usually hypoallergenic options available, but the patient’s parents should be aware of the unexpected potential risks.5
Spina bifida may require surgery as a form of treatment. The hole in the patient’s back can be closed. However, that will not restore spinal cord functionality which has been lost. There are investigations into the safety and efficacy of intrauterine surgery, which is invasive treatment that is performed before the patient’s birth. Nonetheless, the most effective thing to do is to prevent spina bifida by taking folic acid before pregnancy. There is no cure for the nerve damage which this disease has already caused. A surgically inserted shunt can help drain the cerebrospinal fluid, the abdomen, or the chest.
Many teams work together to continuously help patients cope with spina bifida. These include physiatrists, orthopedists, neurosurgeons, neurologists, urologists, ophthalmologists, physical therapists, occupational therapists, speech therapists, and psychologists. Orthotists can design “assistive technology”, such as braces, wheelchairs, walkers, and crutches.6 Obesity can be a problem in people who have spina bifida, and this could affect daily living and put patients at an increased risk of developing yet more diseases. Exercise and healthy eating can help prevent obesity as well as contribute to the patient’s overall physical and mental health.7
A case study of a young boy who had both bowel and urinary incontinence showed the promise of chiropractic care and its usefulness in treating some part of spina bifida. During the case study, the chiropractor used the Activator and shortwave diathermy over the course of several treatments, and the young patient achieved control over his bowel and bladder at a satisfactory level.8 It is not uncommon for patients to seek chiropractic and massage care. These can be very safe therapies and options as part of treatment, as long as certain precautions are taken to protect the patient of this congenital disorder. Practitioners should be careful around shunts, avoid rapid head twists, and be aware of applying too much pressure to certain regions.9
7, 9 http://www.kintera.org/site/c.liKWL7PLLrF/b.3077279/k.59D2/FAQ_about_Spina_Bifida.htm
Find out more information about chiropractic in the paralyzed.