Management of Pediatric Patients with Spina Bifida

Abstract

Spina bifida is a neurodevelopmental disorder and belong to most common congenital malformations. It is a neural tube defect that originates within first 28 days after conception. Although survival rate of these patients had changed rapidly within last decades, neural tube defects are still cause of substantial part of children morbidity. Occult type of spina bifida is a simple nonunion of vertebral arch without causing any symptoms. Open defects according to degree of involvement of neural tissue cause symptoms such as paralysis of lower extremities, bladder and bowel morbidity, delay in development of cognitive functions of various severity and other possible complications affecting morbidity of these patients. Early diagnosis and treatment of open spina bifida and accompaying complications is crucial and largely affects the outome. Succesfull treatment requires lifelong cooperation of a whole range of specialists and guiding of treatment by primary care doctor. Survival and quality of life are associated with acces to proper medical and surgical treatment as well as community support systems. This chapter offers overview of this topic with emphasis on general management of patients suffering from this congenital malformation.

An Overview of Spina Bifida

“…It is the least severe [32] and asymptomatic [33] but most common form of spina bifida where the outer part of the vertebrae is not closed enough [34]. The skin at the site usually seems to be normal, but sometimes, hair growing, dimples or birthmarks are detected [33].…”

“…It is the least severe [32] and asymptomatic [33] but most common form of spina bifida where the outer part of the vertebrae is not closed enough [34]. The skin at the site usually seems to be normal, but sometimes, hair growing, dimples or birthmarks are detected [33]. Alpha fetoprotein (AFP) which is a common diagnostic tool to screen NTD in utero is not observed to be increased in this case due to the well maintained dural lining and accidentally diagnosed from spinal X-rays [35].…”