Spina Bifida is a congenital disorder which comes under the category of neural tube defects.1 Children with Spina Bifida have underdeveloped spine and spinal cord. Neural tube is an embryonic structure that is present in the first trimester of the pregnancy and closes by the end of the first month of conceiving. This neural tube closes and ultimately develops into brain, spinal cord, and tissues that enclose these structures.
There is no cause that has been identified which leads to the development of Spina Bifida, but there are certain risk factors like folate deficiency, diabetes, obesity which have been linked to increased likelihood of a female delivering a child with Spina Bifida. This condition may range from mild to severe depending on the type, location, and size of the defect.
Despite the advancement that medical science has made in the field of neural tube defects over the last three decades, there are still some long term problems that children with Spina Bifida have to face with.
What Are The Long Term Effects Of Spina Bifida?
Some of the long term effects of Spina Bifida are:
Urinary and Renal Problems
In majority of cases, children with Spina Bifida require antibiotics lifelong as they are susceptible to infections. Children with Spina Bifida tend to have bladder overactivity which will require therapy and medications long term. They may also require intermittent catheterization throughout their lives to overcome this problem. Even this form of treatment may not resolve the problem and some children with spina bifida may continue to have bladder overactivity and may have urinary incontinence. This may also affect the functioning of the kidneys as well in the long run.
Some children require a bladder surgery to address the issue of bladder overactivity in which the bladder is extended so that it can hold more urine and the problem of urinary incontinence is controlled to some extent. This is quite a complex surgery but in majority of the cases this surgery completely addresses the issue of urinary incontinence.
In addition to bladder problems, children with Spina Bifida also have to deal with bowel problems, in that they tend to have difficulties controlling their bowels.2 Constipation is the most common problem that children with Spina Bifida have to deal with. This problem however can be addressed by medicines and suppositories.
In some cases enemas may have to be used for constipation in children with Spina Bifida. Bowel washouts may have to be performed in cases where none of the conservative treatments work and the child remains constipated.
In case if a child has hydrocephalus because of Spina Bifida, then a surgery may have to be performed to correct this condition. During the surgery, a shunt will be inserted.2 The problem with shunt insertion is that it may get blocked in some instances or may get infected and may have to be treated aggressively. It may or may not require further surgery. A repeat surgery is mostly required for shunts that are blocked even though it is a high risk surgery.
Ambulation problem is a condition that a child with Spina Bifida will have to deal with. If the defect is high on the spine near the head then the lower limbs will be completely paralyzed and the child will be completely dependent on a wheelchair for any sort of movement.
However, if the defect is lower in the spine more towards the hip region then there may not be much of a problem with regard to ambulation in children with Spina Bifida. Such children may or may not require assistive devices for ambulation.
In some cases, children may need use of a crutch, brace or a walker for ambulation. Children with movement disorders due to Spina Bifida need close orthopedic followups and in some cases surgeries may be required for abnormalities in the foot, ankle or knees.
Lack of Sensation
This is yet another long term problem that children with Spina Bifida have to deal with. Just like the muscles in the lower extremities get affected, the nerves may similarly get affected leading to numbness and lack of sensation in the legs.2 The severity of the lack of sensation will depend on the severity and location of the Spina Bifida.