Spina Bifida Treatment
There is no cure for spina bifida. The nerve tissue that is damaged or
lost cannot be repaired or replaced, nor can function be restored to the damaged nerves.
Treatment depends on the type and severity of the disorder. Generally, children with the
mild form need no treatment, although some may require surgery as they grow.
The key priorities for treating myelomeningocele are to prevent infection from developing
through the exposed nerves and tissue of the defect on the spine, and to protect the
exposed nerves and structures from additional trauma. Typically, a child born with spina
bifida will have surgery to close the defect and prevent infection or further trauma
within the first few days of life.
Spina Bifida Treatment Fetal Surgery
Doctors have recently begun performing fetal surgery for treatment of
myelomeningocele. Fetal surgerywhich is performed in utero (within the
uterus)involves opening the mothers abdomen and uterus and sewing shut the
opening over the developing babys spinal cord. Some doctors believe the earlier the
defect is corrected, the better the outcome is for the baby. Although the procedure cannot
restore lost neurological function, it may prevent additional loss from occurring.
However, the surgery is considered experimental and there are risks to the fetus as well
as to the mother.
The major risks to the fetus are those that might occur if the surgery stimulates
premature delivery such as organ immaturity, brain hemorrhage, and death. Risks to the
mother include infection, blood loss leading to the need for transfusion, gestational
diabetes, and weight gain due to bed rest.
Still, the benefits of fetal surgery are promising, and include less exposure of the
vulnerable spinal nerve tissue and bones to the intrauterine environment, in particular
the amniotic fluid, which is considered toxic. As an added benefit, doctors have
discovered that the procedure affects the way the brain develops in the uterus, allowing
certain complicationssuch as Chiari II with associated hydrocephalusto correct
themselves, thus, reducing or, in some cases, eliminating the need for surgery to implant
Many children with myelomeningocele develop a condition called progressive tethering, or
tethered cord syndrome, in which their spinal cords become fastened to an immovable
structuresuch as overlying membranes and vertebraecausing the spinal cord to
become abnormally stretched and the vertebrae elongated with growth and movement. This
condition can cause loss of muscle function to the legs, bowel, and bladder. Early surgery
on the spinal cord may allow the child to regain a normal level of functioning and prevent
further neurological deterioration.
Some children will need subsequent surgeries to manage problems with the feet, hips, or
spine. Individuals with hydrocephalus generally will require additional surgeries to
replace the shunt, which can be outgrown or become clogged.
Spina Bifida Treatment - Assitive Devices
Some individuals with spina bifida require assistive devices such as
braces, crutches, or wheelchairs. The location of the malformation on the spine often
indicates the type of assistive devices needed. Children with a defect high on the spine
and more extensive paralysis will often require a wheelchair, while those with a defect
lower on the spine may be able to use crutches, bladder catherizations, leg braces, or
Treatment for paralysis and bladder and bowel problems typically begins soon after birth,
and may include special exercises for the legs and feet to help prepare the child for
walking with braces or crutches when he or she is older.