Spina Bifida

By Meg Marinis, Director of Medical Research May 05, 2011
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Derek Shepherd dancing with a baby. COME ON. Not only did Derek treat Zola's hydrocephalus and make her feel better, but now he wants to adopt her. COME ON.

If that's not McDreamy, then what the heck is?!

PS: That baby might be one of the most adorable actors to ever set foot on the Grey's Anatomy set. We're all smitten and were happy just staring at her cute smile. Especially Nurse Linda Klein. Can't find Linda? Look for Baby Zola. Really, I don't know how any work gets done when that baby's around.

Spina Bifida literally means "split spine."

It occurs when a baby's spinal column does not close all the way while in the womb. Spina Bifida is the most common birth defect, yet it can cause lifetime disabilities. According to the Spina Bifida Association, eight babies are born everyday in the United States with Spina Bifida or a similar birth defect.

There are actually four types of Spina Bifida:

Spina Bifida Occulta is the least severe form of the defect. Nicknamed "hidden Spina Bifida," this type may not cause any kind of spinal disturbance for the child. People can actually have Spina Bifida Occulta and never know, unless they have an X-Ray of the back. Basically, the defect is confined to a small alteration or gap in a few of the small bones (vertebrae) that comprise the spine.

Occult Spinal Dysraphism (OSD) can be described by the spinal cord not growing the correct way, causing issues as the child grows. Signs of OSD on an infant include a dimple on the lower back, red marks, small lumps, or tufts of hair. If a parent suspects a problem, they should take their infant to a doctor for further tests.

The type Meningocele is when part of the spinal cord, the protective coverings called the meninges, protrudes through an open part of the spine, like a sac being pushed outward. This sac contains cerebrospinal fluid. Usually, this form of Spina Bifida does not cause permanent nerve damage, but problems and minor disabilities may arise. Baby Zola has this type of Spina Bifida.

Myelomeningocele is the most severe form of Spina Bifida. Causing nerve damage and serious disabilities, the meninges and spinal nerves protrude through the open part of the spine. Along with the spinal impairment, these children can also suffer from too much fluid on the brain (hydrocephalus) which may inflict brain damage if left untreated.

According to the Spina Bifida Association, 95% of neural tube defects occur in women with no personal or family history of it. But some risk factors include:

- A previous pregnancy with a defect increases the chances.
- Race/Ethnicity.
- Lower socio-economic status.
- Medically diagnosed obesity.
- Maternal insulin-dependent diabetes.
- Use of certain anti-seizure medications.
- High temperatures in early pregnancy (prolonged fevers, hot tub use, etc.).

What kinds of treatments exist for Spina Bifida?

Well technically, nothing can completely cure the defect because nerve tissue cannot be replaced or fixed. But depending on the effects and form of the defect, various surgeries, medications, and physiotherapy can treat the symptoms and disabilities. For example, for meningocele and myelomeningocele, surgery can be done to close the spinal opening on an infant shortly after birth to reduce chances for infection and preserve existing function in the spinal cord. If a child must live with serious motor impairments throughout life, he or she may need assistance from wheelchairs, crutches, or braces. But regardless of how the infant presents at birth, affected children should consistently see a doctor to be monitored and examined for any additional problems that may arise from the defect.

The latest developments for treatment include intrauterine surgery, which has been reported successful. Still in its clinical trial stage, these surgeries have shown to decrease neurological problems in children with Myelomeningocele Spina Bifida as well as improve their ability to walk. However, prenatal surgery does come with risks to both the fetus and the mother that must be strongly considered.

To prevent children being born with Spina Bifida, doctors recommend mothers take folic acid during pregnancy.

Folic acid (or "folate") is a B vitamin that helps the body make new cells. Folic acid is found naturally in some foods such as broccoli, spinach, egg yolks, and oranges. Everyone needs folic acid in their diet, but medical researchers have discovered that pregnant women extremely need it to prevent certain birth defects like Spina Bifida and Anencephaly. Doctors prescribe 400 to 800 micrograms daily for women able to get pregnant, even if they are not planning a pregnancy. Women should consult with their doctors on the correct amount of folic acid they might need, especially if:

- You are pregnant or are planning to get pregnant.
- You are breastfeeding.
- You previously had a baby with a birth defect and want to get pregnant again.
- You have Spina Bifida and want to get pregnant.
- You have a family member with Spina Bifida and want to get pregnant.

For more information, please visit:

http://www.cdc.gov/ncbddd/folicacid/index.html

http://www.cdc.gov/ncbddd/spinabifida/index.html