WHAT IS SPINA BIFIDA?

Spina bifida is a birth defect. Most children who have spina bifida do not have problems from it. It occurs when bones of the spine (vertebrae) do not form properly around part of the baby’s spinal cord. It can effect how the skin on the back looks. In severe cases, it can make walking or daily activities hard to do without help. This disease can either be mild or severe.

 

Type of mild form

 

  1. SPINA BIFIDA OCCULTA

–          Occulta is in latin = “hidden”

–          Outer part of some of vertebrae is not completely close.

–          Splits in vertebrae are small that the spinal cord does not protrude.

–          Skin may be normal or it might have some hair growing from it.

–          There may be a dimple in the skin or a birthmark

 

2 types of severe form

 

  1. MENINGOCELE

–          Fluid leaks out of spine and pushes against skin.

–          May see bulging against skin.

 

  1. MYELOMENINGOCELE

–          The most rare and severe form of spina bifida

–          Part of spinal nerves push out of spinal cord which may cause bulging of skin

–          Nerves often damaged which may cause problem with:-

ü  Walking

ü  Bladder/bowel control

ü  Co-ordination

ü  In some cases, skin is open and the nerves is exposed

 

Cause of spina bifida

the exact cause of spina bifida remains unknown, but some suspects that the cause is  multifactoral:-

  • Genetic
  • Nutritional
  • Environmental surrounding
  • Insufficient intake of folic acid

 

SIGN & SYMPTOM

–          Small, hairy patch, dimple or birthmark on lower spine

–          Fluid-filled sack protruding along back bone area

–          Sac-like mass of nerves and spinal cord that protrudes from the back

–          Loss of sensation and movements in legs and feet (paralysis)

–          Poor bladder control (incontinence)

–          Poor bowel control (constipation)

 

PHYSIOTHERAPIST’S MANAGEMENT

  • Maximising independence in functional activities such as standing, transferring and walking
  • Provision of mobility aids and equipment to increase independence
  • Exercises to maintain or improve muscle strength and length
  • Anticipating, preventing and minimising secondary effects such as development of contractures
  • Positioning and postural advice
  • Teaching wheelchair skills to maximise independence
  • Provision of appropriate orthotics
  • Exercises to improve balance and coordination to prevent risk of falls

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