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Uploaded byRadhika Ahuja
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Spina bifida ppt

Spina bifida is a birth defect where the spinal cord fails to develop properly, causing part of the vertebrae to remain unfused and open. It occurs early in pregnancy from the incomplete closing of the neural tube. The most common type is myelomeningocele, which affects females slightly more and can cause various physical disabilities. While the cause is unknown, folic acid deficiency and certain drugs have been linked as risk factors. Prenatal screening and early postnatal care aim to monitor development and prevent infections. Managing symptoms may involve surgery, physical therapy, catheters, and antibiotics.

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Presented by : Radhika Ahuja BPT 3rd year
 Latin : “ Split spine” Developmental congenital disorder  caused by incomplete closure of embryonic neural tube  Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open
 Opening is large enough that this allows spinal cord to protrude through it  there may or may not be a fluid filled sac around spinal cord
 Worldwide incidence of one or two causes per 1000 birth  Myelomeningocele, most significant common cause , this leads to disability in most affected indivdual  more likely to affect females , idiopathic cause
 Unknown etiology  Genetic predisposition triggered by environmental factors- drugs “Valpronic Acid” during pregnancy  Women age more than 35 years  Women already have 1 child affected  Maternal Folic acid deficiency , 0.4 mg/day during 1st trimester
 Arrest in the orderly formation of vertebral arches and spinal column between 4-6th wk of pregnancy  Incomplete closure of neural tube during 4th week of embryonic age  The neural tube forms adequately and then ruptures
Spina bifida malformation lies in three categories: A. spina bifida occult ( 10% of the population) B. spina bifida cystica with meningocele C. spina bifida cystica with myelomeningocele ( most common site are sacral and lumbar)
 Occult means “Hidden” (Mildest form)  Here , outer part of some vertebrae is not completely closed  Split is small thus S.C do not protrude  Site of lesion is normal but may have some growing hairs , a dimple in the skin , or a birthmark
 Least common form of spina bifida is posterior meningocele  Here, vertebrae develops normally but meninges are forced into the gap between the vertebraes.
 This gives more severe complications  Here , unfuse portion of spinal column allows spinal cord to protrude through an opening  Meningeal memebrane encloses spinal cord form a sac enclosing spinal elements  Spina bifida with myeloschisis is most severe form of myelomeningocele ,  Involved area is represented by flattened , plate-like mass of nervous tissue with no overlapping membranes
 Exposure of these nerves and tissues make the baby more prone to life –threatening infections such as meningitis  Protrudes nerves are damaged or not properly formed  As a result , there is usually some degree of paralysis and loss of sensation below level of spinal cord defect.
 PHYSICALSIGNS ;  Orthopedic abnormalities ( i.e Club foot , Hip dislocation )  Bowel and Bladder incontinence  Urinary tract infections  Poor renal function  Pressure sores and skin irritation  Abnormal eye movement
 68% affected people have allergy to latex  Paralysis  Scoliosis  Back pain  Partial or complete loss of sensation  Weakness of hips, legs , feet of a newborn
 OTHER SYMPTOMS ARE ;  Growing hairs at the back part of the pelvis  Dimpling of sacral area  Difficulty in swallowing , lead to chocking  Hoarseness  Below average IQ
 Many individual with spina bifida have an associated abnormality of cerebellum called ARNALD CHIARI II MALFORMATION  Here , back portion of the brain is displaced from the back of the skull down into the upper neck
 Specific area of difficulty in some individual include; Planning ; Organization ; Initiation ; Memory ; Problem-solving ; Abstraction ; andVisual Planning .  Children with spina bifida and shunted hydrocephalus have higher rate of ADHD
 Individual with spina bifida may struggle academically especially in the subjects like Mathematics and Reading .  In one study ,it is found that 60% of the children with spina bifida were diagnosed with learning disability.
 AFP SCREENING Neural tube defect can usually be detected during pregnancy by testing the mother’s blood  Increased level of MATERNAL SERUM ALPHA FETOPROTEIN (MSAFP) should be follow up to two test : ULTRASOUND OF FETAL SPINE & AMNIOCENTESIS of the mother amniotic fluid for MSAFP and acetylcholinesterase
 FOLIC ACID , dietary supplements has been shown to be helpful in reducing incidence of spina bifida.  pregnant women is recommended to take 0.4 mg of folic acid a day
 There is no known cure for neural damage caused by spina bifida  Spinal cord and its nerve roots are put back inside the spine and covered with meninges  A shunt may be surgically installed to provide continuous drain excessive CSF produce in brain  This shunt most commonly drain into chest
 Monitor growth and development of bones , muscles and joints  Physical therapy  Speech therapy
 Place the child in prone position  Cover the site with the sterile guaze piece dipped in normal saline  Maintain hydration  Monitor for associated defect
 Catheters  Braces  High fiber diet  Antibiotics for meningitis and urinary infections
• Difficult delivery with problem resulting from a traumatic birth , including CEREBRAL PALSY and decreased oxygen to brain • Frequently UTI • Hydrocephalus • Loss of bowel and bladder control • Meningitis • Permanent weakness or paralysis of brain
Spina bifida ppt
Spina bifida ppt