Spina Bifida, also referred to as Myelomeningocele is a bony defect of the spine with a visible or hidden opening into the spinal cord. Spina Bifida may occur as a result of a genetic abnormality, or prenatal exposure to teratogens including excess alcohol or nutritional deficiency including folic acid.
Symptoms and severity of Spina Bifida depends on where the spinal cord is affected. Children affected at the cervical (neck) or thoracic (upper back) level will have more complications than children affected in the lumbar (lower back) region.
Many children with Spina Bifida also have additional medical diagnoses. Hydrocephalus (excess fluid inside the skull) is a concern for many children with Spina Bifida. A shunt is required in 80% of children.
Bowel and bladder complications are common as well as orthopedic complications. Orthopedic considerations include spine and lower limb deformities, joint contractures, muscle weakness, limitations in movement, and difficulty with activities of daily living.
Children with Spina Bifida may also experience sensory deficits, poor coordination, thinking and language difficulties, difficulty with visual perception, and obesity.
Diagnosis and Therapy
Most parents know there child has Spina Bifida before birth as it can be seen during an ultrasound. The initial newborn assessment includes a neurological and physical exam of the level of lesion, motor weakness, sensation, and anal tone.
However, mild cases may not be diagnosed until after birth. These cases are diagnosed by x-ray, MRI, or CT scan of the spine and vertebrae.
Spina Bifida Clinic at Primary Children’s Medical Center takes a multi-disciplinary approach to the evaluation and treatment of Spina Bifida. The clinic includes Nursing, Neurology, Orthopedics, Nutrition, Social Work, Physical Therapy, Occupational Therapy, Speech Language Pathology, and an equipment vendor.
Common Physical Therapy Treatment Intervention:
- Equipment Evaluation
- Muscle Strengthening
- Transition and transfer training
- Gait training
- Coordination and Balance
Common Occupational Therapy treatment intervention:
- Equipment Evaluation
- Hand function – self feeding, putting on and fastening clothing, tying shoes, writing, etc.
- Managing clothing and hygiene to use the bathroom
- Independent living skills