October is Spina Bifida Awareness Month.

What is Spina Bifida?
Spina Bifida happens when the spine of a baby in the womb does not close all of the way.  It occurs within the first month of pregnancy — often before most women even know that they are going to have a baby.  Every day, about eight babies born in the United States have Spina Bifida or a similar birth defect of the brain and spine. Spina Bifida is the most common permanently disabling birth defect that is compatible with living into adulthood.

What causes Spina Bifida?
No one knows for sure. Experts think that both genetics (one or more genes) and the person’s environment might interact to cause Spina Bifida. It is possible that a person inherits multiple genes that make them susceptible to having Spina Bifida, but something in the environment triggers the Spina Bifida to develop.

Can Spina Bifida be prevented? 
There is no way to prevent a baby from having a birth defect. It is only possible to reduce the risk. Studies show that the risk is reduced up to 70 percent when women take folic acid before and through the first three months of pregnancy. Folic acid does not stop all cases of Spina Bifida. There is still a chance that some babies will have it even when women take the right amount every day.

Who is at risk for having a baby with Spina Bifida?
Any woman who is capable of becoming pregnant can have a baby with Spina Bifida.  Although people with a first-degree relative (parent, sibling) with Spina Bifida are 5 to 10 times more likely to have Spina Bifida than the greater population, there is no way to tell which women will have babies with Spina Bifida. Ninety-five percent of people with SB have no family history. Many things affect pregnancy, including genes, environment and certain illnesses or drugs. These include:

  • Prior pregnancy with Spina Bifida (the chance of the next pregnancy being affected is 20-50 times greater)
  • Family history of SB
  • Mother with insulin-dependent diabetes
  • Mother’s use of certain anti-seizure drugs
  • Mother with medically diagnosed obesity
  • Race and ethnicity. (SB is more common in Caucasians than African-Americans and more common in Hispanics than non-Hispanics.)

What conditions are associated with Spina Bifida?
Children and young adults with Spina Bifida can have mental and social problems. They also can have problems with walking and getting around or going to the bathroom, latex allergy, obesity, skin breakdown, gastrointestinal disorders, learning disabilities, depression, tendonitis and sexual issues.

Spina Bifida Occulta
It is often called “hidden Spina Bifida” because about 15 percent of healthy people have it and do not know it. Spina Bifida Occulta usually does not cause harm, and has no visible signs. The spinal cord and nerves are usually fine. People find out they have it after having an X-ray of their back. It is considered an incidental finding because the X-Ray is normally done for other reasons. However, in a small group of people with SBO, pain and neurological symptoms may occur. Tethered cord can be an insidious complication that requires investigation by a neurosurgeon.

Spinal Cord Tethering
A common cause of deterioration in Spina Bifida

What is spinal cord tethering?
Tethering of the spinal cord is a condition in which the spinal cord becomes attached to the spinal column via surrounding structures. Normally, the spinal cord hangs loose in the canal, freely moving up and down with growth, bending and stretching. A tethered cord does not move. It is pulled tightly at the end, reducing blood flow to spinal nerves and causing damage to the spinal cord from both the stretching and the decreased blood supply.

How does tethering occur in milder forms of Spina Bifida?
Tethering, usually in adults with milder forms of SB may be related to the degree of strain placed on the spinal cord over time, and may be significantly worsened during physical activity, injury, or pregnancy. It may also be caused by narrowing of the spinal column (stenosis) or bony spurs.

A tethered cord may go undiagnosed until adulthood.  Delayed presentation of symptoms can be insidious, meaning that symptoms come on slowly over time, but can be complex and severe. Back pain, brought on or worsened by activity and relieved with rest, can be a sign of tethering. Sometimes back pain is also associated with leg pain, even in areas that have decreased or no sensation. Changes in leg strength, deterioration in gait (walking), progressive or repeated muscle contractures, orthopedic deformities of the legs, scoliosis, and changes in bowel or bladder function may be signs of tethering.

All of these facts came from the website of the Spina Bifida Association.  If you would like to learn more please go here.

I was born with Spina Bifida.  I had an acquaintance die from complications of Spina Bifida.  I have a mild form of this birth defect, but some people are severely crippled with it.  It would be a good thing if more people (especially women of child bearing years) were aware of Spina Bifida so they could take steps such as taking folic acid before & during pregnancy to prevent more children born with this birth deftect.