Among the various abnormalities that can occur during fetal development, one that is not very well known is spina bifida, also called bifurcated spine by doctors. Spina bifida is a congenital malformation considered common because it occurs in many cases and is characterized by improper formation and closure of the embryo’s neural tube.

The problem develops during the first two months of pregnancy, when some vertebrae that cover the spinal cord do not fully form, leaving an open space in the area. With this open space, the spinal cord ends up protruding and projecting outside of the bones, making it easily visible externally. There are three types of anomalies related to spina bifida malformations: meningocele, myelomeningocele, and occult spina bifida.

  • Meningocele – Considered the mildest form of spina bifida, meningocele creates a small lump on the baby’s back involving only the protective structures of the spinal cord, but keeps the cord inside the vertebrae as expected.
  • Myelomeningocele – Considered the most severe form of spina bifida, in addition to a large visible lump, the protective structures of the spinal cord are completely open. This causes the baby to have neurological issues that prevent the transmission of nerve impulses.
  • Occult Spina Bifida – The most common type to occur and characterized by incomplete closure of the spine, but does not involve the spinal cord or its protective layers. As this type does not affect the neurological system, it may go unnoticed. One of the usual signs is the presence of hair or a mark on the region.

Among the main causes of this condition are older parental age, diabetic mothers, lack of folic acid in the mother’s body, alcohol consumption during pregnancy, and genetic disorders. Spina bifida can be diagnosed through an ultrasound exam in the first trimester of pregnancy.

Treatment for Spina Bifida

The appropriate treatment for spina bifida depends on its type, and in many cases no treatment is required. As mentioned above, in the case of occult spina bifida the condition may go unnoticed because it does not present any symptoms or difficulties for the child. Generally, the recommended treatment is through repair surgery, which should be performed in the first days of the baby’s life. The purpose is to place all the internal structures of the spine in the correct position, thereby closing the deformity. However, it is important to note that this surgery almost never prevents the neurological problems caused by spina bifida.

In cases of myelomeningocele, the baby should also undergo surgical repair in the first days after birth. Until surgery is performed, the baby must be kept lying on its stomach, allowing the small opening to remain facing upward and covered with gauze soaked in saline solution, thus minimizing the risk of infection at the site. If hydrocephalus occurs along with spina bifida, the removal of excess fluid from the brain should also be done by surgery, aiming to reduce and prevent further complications in the child’s health. In addition to surgery, physical therapy plays an important role in treatment with the goal of strengthening the spine and the muscles of the bowel and bladder and promoting greater independence for the child; in some cases, teaching and strengthening them to walk or even use a wheelchair. Physical therapy sessions also help decrease and prevent the development of deformities in the area, as well as increase control over the body.

See also: Folic Acid in Pregnancy Prevents Malformation

Photos: Laurinda, rafaelgenu