Spina Bifida comes from the word for “split spine in Latin (Webster, 1997). It is a serious birth defect that occurs when the tissue surrounding the developing spinal cord of a fetus doesn't close properly. Its part of a group of birth defects called neural tube defects (Spinal Bifida Association of America, 2006). The neural tube is the embryonic structure that eventually develops into the baby's brain and spinal cord and the tissues that enclose them. In normal circumstances, the neural tube forms in the developing baby early in the pregnancy and closes by the 26th day after conception (Spinal Bifida Association of America, 2006). Later, the top of this tube becomes the baby's brain, and the remainder of the tube becomes the baby's spinal cord. In babies with spina bifida, a portion of the neural tube fails to develop or close properly, causing defects in the spinal cord and in the bones that make up the backbone (Gilman & Newman, 1996). This can also occur in the middle or upper end of the spine but is most common in the lower spine. Professor Nicholas Tulp gave spina bifida its name and gave the first formative description of the disability. Although the term and real medical description are somewhat recent, it is estimated that spina bifida occurred almost 12,000 years ago. Types of Spina Bifida
There are three types of spina bifida: spina bifida occulta, meningocele, and myelomeningocele: Spina bifida occulta
Spina bifida occulta is the mildest and most common form of this disorder. It usually only involves a minor fault with one or two of the vertebrae and it usually shows no symptoms nor requires treatment. When an infant is born with spina bifida occulta, the skin is normal and covers the deformity of the spine. Spina bifida occulta literally means "a hidden spot on the spine," and for most people, this spot will remain hidden. It has been estimated that approximately 10 percent of the American population has spina bifida occulta and that most are not even aware they have it (Spinal Bifida Association of America, 2006). Rarely spina bifida occulta will cause problems when a child grows to adolescence. By this time in the child’s life, the spinal cord has become fastened to the backbone, so when the growth spurts of adolescence begins; the nerves of the spinal cord become stretched. The result can be difficulties such as weakness and numbness in the legs, bladder infections, and incontinence (lack of bladder and bowel control) (Spinal Bifida Association of America, 2006). The more the spinal cord is stretched, the worse the symptoms become. Surgery to relieve these symptoms by reducing the tension on the spinal cord is simple and often successful. Meningocele
In this least common type of spina bifida, the meninges (membrane surrounding the spinal cord) protrude through the opening causing a lump or sac on the back. More severe than spina bifida occulta, meningocele can nevertheless be repaired through surgery with little or no nerve damage resulting. The surgery is performed at any time during infancy. With meningoceles, the spinal cord has developed normally and is undamaged (Spinal Bifida Association of America, 2006). The child, therefore, has no neurological problems. Myelomeningocele
Myelomeningocele is the most severe form of spina bifida, occurring nearly once for every 1,000 live births (Spinal Bifida Association of America, 2006). For infants born with a myelomeningocele, the spinal cord does not form properly and a portion of the undeveloped cord protrudes through the back (Williamson, 1997). A sac containing cerebrospinal fluid and blood vessels surrounds the protruding cord, which is usually not covered by skin so that the nerves and tissues are exposed. Between 70 and 90 percent of infants born with myelomeningocele also experience hydrocephalus (Spinal Bifida Association of America, 2006). Hydrocephalus is an excess build up of spinal fluid on the brain that will cause brain...
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