Paralysis Resource Guide - (Page 30) CONDITIONS SPINA BIFIDA Spina bifida is the most common permanently disabling birth defect in the United States. One out of 1000 newborns in the United States is born with spina bifida; each year 4000 pregnancies are affected by spina bifida. About 95 percent of babies with spina bifida are born to parents with no family history. Spina bifida, a type of neural tube defect (NTD), means “cleft spine,” or an incomplete closure in the spinal column. This birth defect occurs between the fourth and sixth weeks of pregnancy when the embryo is less than an inch long. Normally, a groove in the middle of the embryo deepens, allowing the sides to meet and enclose the tissue destined to be the spinal cord. In spina bifida, the sides of the embryo do not fully meet resulting in a malformed neural tube, affecting the spinal column and in many cases, forming a spinal cord cleft, or lesion. The most serious form of spina bifida may include muscle weakness or paralysis below the cleft area, loss of sensation below the cleft, and loss of bowel and bladder control. There are three general types of spina bifida (listed below from mild to severe). Spina bifida occulta: This is an opening in one or more of the vertebrae (bones) of the spinal column without apparent damage to the spinal cord. Approximately 40 percent of all Americans may have spina bifida occulta, but because they experience little or no symptoms, very few of them ever know that they have it. Meningocele: The meninges, or the protective covering around the spinal cord, pushes out through the opening in the vertebrae in a sac called the meningocele. The spinal cord remains intact; this can be repaired with little or no damage to the nerve pathways. Myelomeningocele: This is the most severe form of spina bifida, in which a portion of the spinal cord itself protrudes through the back. In some cases, sacs are covered with skin; in others, tissue and nerves are exposed. A common effect of myelomeningocele is an accumulation of fluid in the brain (hydrocephalus). A large percentage of children born with myelomeningocele have hydrocephalus, which is controlled by a surgical procedure called shunting. This relieves the fluid buildup in the brain and reduces the risk of brain damage, seizures or blindness. Hydrocephalus 30
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