Spina Bifida - Medical Malpractice Lawyers

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Spina Bifida - Medical Malpractice

Spina bifida is a specific type of birth defect that involves the incomplete closure of the neural tube in the base of the spine. Most kids do not have any symptoms from the condition, which is then called spina bifida occulta. This happens when the bones of the spine or the vertebrae do not completely surround the spinal cord at the base of the spinal area and the skin of the back can form a dip or, in more severe cases, can fail to form at all. Only a membrane can separate the spinal cord from the outside, which can lead to infection. More severe cases of spina bifida cause paralysis of the lower extremities.

Fortunately, the milder form of spina bifida is more common than the severe form. You can see it on x-ray but it doesn't cause any major symptoms. There are two types of the severe form of the disease. In a meningocele, the fluid pushes against the skin from the spinal canal, leading to a bulge in the skin at the base of the spine. In a myelomeningocele, the spinal nerves push out of the spinal canal and the skin bulges and there are problems with bowel and bladder control and paralysis or uncoordination of the lower legs. The skin can be open and the nerves can be exposed, leading to infection potential.

No one knows the cause of spina bifida. It may be related to genetic problems or to environmental things such as diabetes and obesity in the mother. It is also believed that a lack of folic acid in pregnancy contributes to spina bifida.

The symptoms of spina bifida depend on how severe the problem is. There may only be a dimple in the skin or a birthmark at the base of the spine. Some kids have a hairy patch of skin at the site of a spina bifida lesion. Severe cases of spina bifida may allow the nerves to be visible coming outside of an open area of the skin. There can be no sensation or movement of the feet, legs or even arms. These kids are often born with hydrocephalus or fluid build up in the brain. It can also happen after birth and can lead to seizures, visual problems or mental slowness. Scoliosis is also common in kids with spina bifida. Often, children with spina bifida that is severe are also sufferers from latex allergy.

The diagnosis of spina bifida can happen in the womb. Women can have a triple screen or quadruple screen which can tell whether or not there is a chance of spina bifida. An ultrasound can show whether or not there is enough space between the skin and the spinal cord, suggestive of a normal spine. Amniocentesis can also show whether or not there are high levels of alpha fetoprotein, suggestive of a spinal cord injury. MRI, CT scan or X-ray can show if there is a severe or mild defect of the spinal vertebrae.

The treatment of spina bifida varies depending on how severe the defect is. If there is only a bony defect, nothing more is done and the condition is called spina bifida occulta. If the bony defect is severe, surgery may be necessary to put the spinal nerves back where they belong and close the skin overlying the spinal cord at the base of the spine. Some children may need physical therapy shortly after birth and may need a wheelchair after they reach a certain age. This is reserved for children who have severe deficiencies due to spina bifida.

You can prevent spina bifida by eating at least 400 mcg of folic acid each day during the pregnancy. It helps to take in this much folic acid even before you become pregnant so that you don't have to catch up to a folic acid deficiency in early pregnancy. If you take medications for acne or seizures, seek medical advice before you get pregnant so that the potential for spina bifida doesn't occur. Do not drink alcohol during pregnancy and do not expose your body to excessive heat such as in a sauna or hot tub during pregnancy, especially in the first few weeks. This is when the neural tube closes and it doesn't close well under circumstances of high heat.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here