Spina bifida

It refers to a congenital defect of the spine which is represented by the incomplete suture of the vertebral arch determining the incomplete development of the neural tube in the lumbar or sacral regions, during the first three months of the pregnancy.
Classification: According to the importance of this defect and the associated lesions, one can distinguish several lesional degrees:
– spina bifida occulta;
– dermal or epidermal fistulas;
– menigocele;
– myelomeningocele.
Spina bifida occulta represents an elementary lesion, visible only at the X-ray exam, as a partial defect of the posterior vertebral arch. In the lack of a neurological symptomatology and the associated dermal signs, no therapeutic action is needed. The occurrence of the spina bifida occulta is of 10% of the population. Dermal or epidermal fistula: it makes a connection between the dural membrane and the skin passing through a bone defect which may be more or less discreet.
Meningocele: – meninges in Greek meminx= membrane, kele=swelling, the rarest form of the spina bifida, also called meningeal cyst.
Myelomeningocele: – the most frequent and severe form of the spina bifida, with the most severe complications.
Causes and risk factors: It is said that the genetic heredity could be the cause of the spina bifida, in association with the environmental factors, including the folic acid intake. Cytoplasmic factors, polygenic inheritance, chromosomal abnormalities and external influences have also been put forth as causes.
Signs and symptoms: Spina bifida is diagnosed at birth or in utero.
Clinical examination: the main discovered sign is a certain degree of motor or sensitive dysfunction. The neurological affection is classified upon the level of the lesion, according to the specific muscle groups.
Treatment: Children with spina bifida occulta do not usually need any treatment. In the cases of spina bifida aperta, the treatment significantly depends on the type of the spina bifida and the severity of the disease.