Spina Bifida

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About Spina Bifida

定义

Spina bifida (SB) is a problem with how the spine and spinal cord form before birth. It may cause structures that should be inside the spinal canal to 溜出.

The three most common types are:

Occulta—a small defect in one or more backbones that usually does not cause health problems
Meningocele—膜s that poke through an open part of the spine and can form a cyst
Myelomeningocele—膜s that poke through and have nerve roots or spinal cord. This can lead to severe problems

Spina Bifida

原因

The cause is not always known. It is likely due to:

遗传学
The pregnant person not getting enough folate
Environmental factors

Risk Factors

SB is more common in females. Other things that may raise the 风险是:

Having other family members who have had SB
Parent had a prior pregnancy with a baby who had brain, spine, or spinal cord 问题
Low blood level of 叶酸 in the parent when the pregnancy started
Diabetes in the pregnant person
Certain medicines given during pregnancy

症状

SB occulta may not have any symptoms. Some people with this type may never know they have SB. There may be a small tuft of hair or change in skin color over the low back.

The symptoms of meningocele and myelomeningocele are:

A sac filled with fluid leading out from the baby's spine
Spinal cord and tissue that may stick out of the back

诊断

Prenatal Testing

A blood test during pregnancy can predict the risk of SB. If the test predicts a high risk, then two more tests may be done:

Amniocentesis—a sample of the fluid around the baby is taken to measure for things that point to spine problems
超声波—a test that uses sound waves to look at the fetal spine

After Delivery

After delivery, a meningocele and myelomeningocele can be seen. More tests will be done to find out what health problems the baby may have.

Most children with SB occulta will never be diagnosed. It rarely causes any symptoms. It also has few problems. It may be found during a routine medical exam or x射线 of the lower back.

治疗

SB occulta does not need treatment.

Meningocele SB is treated with surgery to remove the cyst.

治疗 for myelomeningocele SB is complex. Options are:

Surgery to put the nerves, 膜, and spinal cord back into place before birth or soon after birth
Physical therapy to help muscles get stronger and to learn how to use devices like walkers, braces, and crutches to move

预防

The risk of having a baby with SB can be lowered by taking 叶酸补充 before and during pregnancy.

参考文献

Phillips, L.A., Burton, J.M.等。. Spina bifida 管理. Current Problems in Pediatric and Adolescent Health Care, 2017; 47(7): 173-177.
Spina bifida. EBSCO DynaMed website. Available at: http://www.力学.com/condition/spina-bifida.
Spina bifida. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-问题/conditions/developmental-disabilities/Pages/Spina-Bifida.aspx.
Spina bifida. National Institute of Neurological Disorders and 中风 website. Available at: http://www.研究所.国家卫生研究院.gov/health-information/disorders/spina-bifida.