How dangerous is a congenital spina bifida, methods of its diagnosis and treatment
Among well-known congenital anomalies hernia of the spinal cord of the newborn is the most common and occurs in 65% of cases. This combined defect is often accompanied by clubfoot, hydrocephalus and other anomalies of intrauterine development of the fetus. In this disease one or more vertebrae is not closed, leading to the formation of cracks, through which the loss of spinal cord with its membranes.
Most often this problem occurs in the lower parts of the spine where the Central channel is closed last. But spina bifida can occur in any other area of the spine. Hernia of the spinal cord belongs to the category of serious diseases and the degree of its severity depends on the size of the area of the nervous tissue deprived of adequate protection.
Thanks to modern equipment and new methods of study of tumor in the fetus found during pregnancy by ultrasound scanning.
causes of congenital hernia of the spinal cord
The Etiology of this defect is not yet studied well enough, so scientists and doctors can't identify the specific causes that lead to herniation of the spinal cord. Many chemical, biological and physical factors during the formation of the fetus affects his body. According to experts, a predisposing factor is a deficiency of folic acid in the mother's body.
If during the study revealed congenital spina bifida, for medical reasons, with parental consent, the pregnancy is terminated. Although the disease is congenital in nature, it by nature is not genetic. If a woman will obtain all the necessary vitamins and minerals, when repeated pregnancy she has a chance to give birth to a perfectly normal child.
Main types of spina bifida
It is Customary to distinguish two types of splitting:
- hidden, considered the most mild form in which there are no symptoms of the disease, and only a slight deepening over the affected spine;
- hernial breakdown – heavy form of the disease with obvious gryzunam protrusion, which includes the spinal cord and cerebrospinal fluid. The pathology may involve nerve roots, then their functions are not violated.
Difficult situation if the education is not only the spinal cord with a portion of its membranes, but also nervous trunks and roots. In this case, the doctors concluded the child had severe movement disorders, sometimes incompatible with life.
Symptoms hernia newborns:
- defects of the lower extremities and their position is incorrect;
- in most cases, congenital spinal hernia is accompanied by manifestations of hydrocephalus, which without treatment leads to disorders of the brain;
- is often marked by partial or complete paralysis of the lower extremities with loss of sensation;
- is almost always a tumor is causing problems with urination and defecation, leading to incontinence of urine and feces.
Methods of diagnostic pathology
Based on some symptoms that you cannot diagnose spina bifida in newborns. The defect can be judged even before the birth of the child by the high content of alpha-fetoprotein in amniotic fluid and maternal blood. After birth, the tumor is clearly defined on the back of a newborn at the bulging leather pouch. Hidden cleavage detected by x-ray examination, although in most cases this malformation of the spine is detected at a Mature age.
The most Difficult to account in determining the form of hernia of the spinal cord that is crucial in the appointment of surgical treatment. Therefore, along with x-rays, done CT scan and ultrasound. With the help of these modern techniques to modify and complete the treatment.
When Troubleshooting, you must take into account that children up to 10-12 years of age not the fusion of the vertebral arches is not a pathology, and is considered one of the development options.
Peculiarities of treatment of spinal hernias in newborns
unfortunately, treatment of this disease is due to certain difficulties. We can say that a hernia of the spine of the newborn is the rare case when it is necessary to take all possible measures to prevent it, how to cure the disease completely impossible.
In General practice patients with this pathology are under constant medical supervision.This is especially important given that spina bifida is often accompanied by manifestations of hydrocephalus.
Problems with urination can be avoided by using various hygienic methods of patient care, and urological procedures. To eliminate chronic constipation, which are the result of violations of the gastrointestinal tract, such children are typically assigned a special diet.
Patients meals should contain more crude fiber of plant origin. Helps to restore partial mobility suffering from congenital hernia patients physiotherapy treatment. Regular receipt of the procedures makes it possible for some sick children to function independently in everyday life.
But very often congenital hernia leads to a wheelchair. Therefore, it is important to teach parents to properly care for a sick child. Specialists in consultations explain to fathers and mothers, what symptoms may indicate a change in the condition of the patient. This is necessary to prevent development of various complications.
With good care of children with congenital cerebrospinal hernia can lead a relatively normal life and even to learn individually. Of course, it all depends on the severity of the disease and the localization of education.
Surgical treatment methods
The Only correct variant in this disease is surgical treatment. Minor defects operation will give the result if its done in the first few days of life after diagnosis. Takes a very cautious approach to the appointment of surgery, as during surgery can be soldered to injure the hernia elements of the spinal cord, leading to neurological disorders.
Extensive defect fix by surgery is difficult, though, to save the life of a child can be. But these children suffer physical and mental retardation.
Surgical treatment consists of removing the SAC of the tumor, followed by grafting of the defect formed in the vertebral arches.
But some methods of surgical treatment tactics is not limited. The desired effect can give only a comprehensive treatment, consisting of several stages. Typically, the process is not complete without the involvement of different specialists: urologist, neurosurgeon, orthopedist and neuropsychiatrist. Because the symptoms of the disease is often confirmed violations of various organs and systems.
All diagnostic procedures and treatment are performed immediately after birth in a specialized clinic staffed with specially trained personnel and necessary equipment.
The main point in the choice of treatment are severe symptoms and the results of the survey.
Optimal treatment will only when it will be removed congenital spinal hernia on the basis of correct evaluation criteria of operability. If the children do have pronounced symptoms of somatic disorders and at considerable length spinal cord tumor, operation is not performed. In such situations, symptomatic treatment is considered as an alternative therapy for such patients.
Treatment of associated anomalies is performed at the earliest timing after it is removed has spina bifida in the child. Children who have symptoms of paresis of the lower limbs require long-term rehabilitation. Assigned massage, gymnastics, physiotherapy. Special attention should be given to developing in a patient at a certain time of day reflex for defecation and urination. The success of the treatment and prognosis largely depend on the form of hernia of the spinal cord, its location and extent.
In conclusion, we note that for the purpose of preventing hernia of the spinal cord in newborns, expectant mother before conception should consult with a geneticist regarding planned pregnancy. This is especially useful if a previous pregnancy was complicated by the splitting of the child's spine.
You should Also balance the power and make sure that the food was sufficient in folic acid. Performing such simple recommendations, you will reduce the risk of having a child with such serious birth defects.