Spina Bifida
Maya Bastian
University of Minnesota
Spina Bifida
Introduction
Spina bifida is a spinal cord malformation caused by a defect of the neural tube (McLone, & Bowman, 2016a). There are three main classifications of spina bifida (McLone, & Bowman, 2016a). Myelomeningocele, the most serious neural tube defect, is visible at birth. Children with myelomeningocele have a cleft in the vertebral column, with a corresponding defect in the skin resulting in a sac of fluid that contains exposed meninges and spinal cord (McLone, & Bowman, 2016a). This leads to malformation of the vertebral column and spinal cord, and ultimately the skull and brain. Therefore myelominingocele can cause numerous impairments such as lower limb paralysis, …show more content…
Folic acid deficiency has been identified as a risk factor for the development of neural tube defects (McLone, & Bowman, 2016a). Certain medications such as valproate or folic acid antagonists also increase risk (McLone, & Bowman, 2016a). Prenatal diagnosis can be done by maternal screening of serum alpha fetoprotein (AFP) levels between 15-20 weeks gestation (McLone, & Bowman, 2016a). Diagnosis is confirmed with ultrasound. Before the 12th week it is possible to see irregularities of the bony spine or a bulging at the fetal back. After the 12th week, it is possible to detect the lemon sign and the banana sign. The lemon sign is an indentation of the frontal bone. The banana sign refers to a banana shaped cerebellum due to a shallow posterior fossa (McLone, & Bowman, 2016a). Other findings that indicate spina bifida are ventriculomegaly, microcephaly, and effacement of the cisterna magnum ( McLone, & Bowman, 2016a) Myelomeningoceles are usually obvious at birth, even if undetected in …show more content…
(2013) performed a comprehensive literature review of the impact of neural tube defects on patients and caregivers. Physical functioning, activities of daily living, pain, emotional functioning, mental health, self-esteem, self-image, social functioning, relationships, and sexual functioning were all affected by spina bifida. One study found that although there are many similarities in impact between cerebral palsy and spina bifida, children with spina bifida were more impacted by bladder and bowel problems. They also had more mobility problems that impact instrumental daily tasks (Rofail, Maguire, Kissner, Colligs, & Abetz-Webb 2013) The authors found that parents face great distress upon diagnosis and that caring for children with spina bifida creates a large workload, decreases quality of life, and takes up a significant amount of time (Rofail, Maguire, Kissner, Colligs, & Abetz-Webb 2013). They also found there is a toll on parental confidence, emotions, mental health, stress, and relationships, The authors cite one study on caregivers of children with cerebral palsy or spina bifida that found caring for the child took up to 29% of their waking time. Rofail, Maguire, Kissner, Colligs, & Abetz-Webb (2013) also point out that the average lifetime direct medical cost per person with spina bifida is about $300,000, not costs such as special education and other
Maya Bastian
University of Minnesota
Spina Bifida
Introduction
Spina bifida is a spinal cord malformation caused by a defect of the neural tube (McLone, & Bowman, 2016a). There are three main classifications of spina bifida (McLone, & Bowman, 2016a). Myelomeningocele, the most serious neural tube defect, is visible at birth. Children with myelomeningocele have a cleft in the vertebral column, with a corresponding defect in the skin resulting in a sac of fluid that contains exposed meninges and spinal cord (McLone, & Bowman, 2016a). This leads to malformation of the vertebral column and spinal cord, and ultimately the skull and brain. Therefore myelominingocele can cause numerous impairments such as lower limb paralysis, …show more content…
Folic acid deficiency has been identified as a risk factor for the development of neural tube defects (McLone, & Bowman, 2016a). Certain medications such as valproate or folic acid antagonists also increase risk (McLone, & Bowman, 2016a). Prenatal diagnosis can be done by maternal screening of serum alpha fetoprotein (AFP) levels between 15-20 weeks gestation (McLone, & Bowman, 2016a). Diagnosis is confirmed with ultrasound. Before the 12th week it is possible to see irregularities of the bony spine or a bulging at the fetal back. After the 12th week, it is possible to detect the lemon sign and the banana sign. The lemon sign is an indentation of the frontal bone. The banana sign refers to a banana shaped cerebellum due to a shallow posterior fossa (McLone, & Bowman, 2016a). Other findings that indicate spina bifida are ventriculomegaly, microcephaly, and effacement of the cisterna magnum ( McLone, & Bowman, 2016a) Myelomeningoceles are usually obvious at birth, even if undetected in …show more content…
(2013) performed a comprehensive literature review of the impact of neural tube defects on patients and caregivers. Physical functioning, activities of daily living, pain, emotional functioning, mental health, self-esteem, self-image, social functioning, relationships, and sexual functioning were all affected by spina bifida. One study found that although there are many similarities in impact between cerebral palsy and spina bifida, children with spina bifida were more impacted by bladder and bowel problems. They also had more mobility problems that impact instrumental daily tasks (Rofail, Maguire, Kissner, Colligs, & Abetz-Webb 2013) The authors found that parents face great distress upon diagnosis and that caring for children with spina bifida creates a large workload, decreases quality of life, and takes up a significant amount of time (Rofail, Maguire, Kissner, Colligs, & Abetz-Webb 2013). They also found there is a toll on parental confidence, emotions, mental health, stress, and relationships, The authors cite one study on caregivers of children with cerebral palsy or spina bifida that found caring for the child took up to 29% of their waking time. Rofail, Maguire, Kissner, Colligs, & Abetz-Webb (2013) also point out that the average lifetime direct medical cost per person with spina bifida is about $300,000, not costs such as special education and other