Spina Bifida

Need Care for Adult Spina Bifida in Orange County? For Next-Gen Treatment of the Spine, There’s No Place Like Hoag.

There was a time when spine-related birth defects like severe spina bifida meant a shorter, less able and more painful life. But with education, new technologies and techniques, fewer children are being born with spina bifida, and those with the condition are living longer, fuller lives.

Do you need evaluation or care for adult spina bifida in Huntington Beach, Irvine, Newport Beach, Tustin or other communities across Orange County? Then you should know you’ve got a very powerful ally right here in the neighborhood, at Hoag. At the Hoag Spine Institute, our comprehensive team of medical pain management and spine surgery experts are committed to setting the gold standard for spine care in Orange County, including for complex congenital conditions like neural tube defects.

Read on for what you need to know about spina bifida, including key definitions, causes and common symptoms. And if you need adult spina bifida care in Orange County, contact the Hoag Spine Institute today at 949-764-1411 or through our online form.

What is Spina Bifida?

Spina bifida is a type of birth defect (an issue that develops in the womb) that affects the development of the spine.

The condition is a type of what’s called a neural tube defect. Spina bifida occurs when the neural tube, the structure in a developing fetus that eventually becomes the brain and spine, doesn’t close up completely as the fetus develops during the early weeks of pregnancy.

As the fetus continues to gestate, that can result in a gap or opening in the spinal column. That can sometimes leave a portion of the spinal cord or spinal nerves exposed, or cause a fluid-filled sac to protrude through the skin of the back.

People with spina bifida can experience a range of symptoms, with the severity depending on several different factors, including the size and location of the opening in the spine, whether the opening is covered by skin and whether any spinal cord or nerve tissue is involved.

What are the Different Types of Spina Bifida?

There are several different types of spina bifida, each with unique characteristics and symptoms. Types include:

Spina Bifida Occulta

A less-severe type of spina bifida, spina bifida occulta is a form of neural tube defect that causes only a small opening in the spine. The condition also doesn’t include a sac that extends through the skin of the back, as in some other forms of spina bifida.

Sometimes called “hidden spina bifida” because skin covers the abnormal opening in the spinal column, spina bifida occulta usually doesn’t cause any symptoms or disability at all. In some cases, a person can go their whole life without knowing they have an issue, with evidence they have spina bifida occulta only discovered accidentally during X-rays or scans of the spine while diagnosing other conditions.

Meningocele

A moderately-severe type of spina bifida, meningocele is a form of neural tube defect that involves a sac that protrudes from the spinal column. This sac, which is usually visible on a baby’s back after birth, is filled with cerebrospinal fluid, and may be covered by a layer of skin or by the meninges — the membranes that protect the spinal cord and nerves. Unlike myelomeningocele, however, this sac does not contain a portion of the spinal cord. As adults, people with meningocele usually have slight functional problems, including minor issues with bowel and bladder function.

Myelomeningocele

The most severe form of spina bifida, myelomeningocele (also called “open spina bifida”) is a form of neural tube defect that also involves a spinal fluid-filled sac that protrudes through an opening in the skin of a baby’s back. Unlike cases of meningocele, however, the sac also contains part of the spinal cord and nerves. Myelomeningocele usually results in damage to these structures, which can cause a range of problems, including some that may be serious.

The symptoms and disabilities that can result from this type of spina bifida vary from person to person, but can range from moderate to severe, including not being able to move the legs, bladder and bowel dysfunction and more.

Myelomeningocele and Chiari II Malformation

Because of the way a neural tube defect can affect the formation of the spinal column and related structures, those with myelomeningocele often have what’s called a Chiari II Malformation.

In those with Chiari II malformation, the lower rear part of the skull develops abnormally small, which can cause a portion of the brain called the cerebellum to be forced into the upper spinal canal. That can impact the normal flow of cerebrospinal fluid that protects the brain and spinal cord, potentially leading to a range of serious issues.

Visit here to learn more about Chiari malformation from Hoag.

Myelomeningocele and Tethered Spinal Cord

Those born with myelomeningocele can also experience what’s called a tethered spinal cord. Normally, the lower end of the spinal cord floats freely inside the fluid-filled spinal canal. In those with myelomeningocele, the spinal cord can become abnormally attached (or “tethered”) to the inside of the spinal canal.

As a baby grows, that attachment can cause the spinal cord to stretch. Stretching can cause a range of serious problems and disabilities, including scoliosis, pain in the testicles or lower part of the body, urinary tract infections, loss of bladder and bowel function and more. Visit here to learn more about scoliosis from Hoag.

What Causes Spina Bifida?

The reason why some people develop spina bifida and other neural tube defects during gestation while others don’t isn’t well understood. However, spina bifida is believed to be caused by certain environmental factors experienced by the mother during gestation, including not getting enough folic acid before pregnancy or in the early weeks of gestation.

Genetic factors may also potentially play a role, as people with a family history of neural tube defects or who have previously given birth to a child with the condition are more likely to have a child with spina bifida.

Other issues that are believed to contribute to the development of spina bifida and other birth defects related to development of the neural tube include being obese, being diabetic and taking certain medications during pregnancy (see Spina Bifida Risk Factors below).

Neural Tube Defects and Folic Acid

One significant factor linked to neural tube defects and spina bifida is a deficiency of folate.

The natural form of folic acid, folate is found in many of the foods we eat, including beans, peanuts, liver, eggs and dark green leafy vegetables like turnip greens, spinach and romaine lettuce. Eating a diet that’s rich in folates can potentially help prevent spina bifida and other neural tube defects if a person becomes pregnant.

Folic acid supplements are also available for those who don’t get enough folate through their diet. Taking folic acid supplements should be seriously considered by all fertile, sexually-active heterosexual women of childbearing age, whether they plan to get pregnant or not. That’s because neural tube defects related to folic acid deficiency often occur in the first few weeks of pregnancy, before a woman knows she’s pregnant.

How much folic acid should I take?

According to the National Institutes of Health, women who could potentially become pregnant or who are trying to get pregnant should consume at least 400 micrograms of folate every day. You should continue taking folic acid through at least the first trimester.

Folic acid supplements are very affordable, and available over the counter at many pharmacies and retail stores. If you did not take a daily folic acid supplement before conception, start taking one as soon as you know you’re pregnant.

What Are the Symptoms of Spina Bifida?

People with spina bifida can experience a range of symptoms, including issues with mobility, the coordination of their muscles, bowel/bladder control and other problems.

Symptoms of spina bifida can include:

Movement and Functional Issues

• Weakness or paralysis in the lower extremities, which can affect the ability to walk or stand.
• Difficulty maintaining balance.
• Lack of muscle coordination.
• Muscle stiffness and muscle spasms.
• Development of orthopedic issues like clubfoot, hip issues or scoliosis.

Bladder and Bowel Issues

• Bowel and/or bladder incontinence, which is the inability to control the release of urine or stool.
• Recurring urinary tract infections (UTIs).
• Problems with completely emptying the bladder or bowels completely.

Other Spina Bifida Symptoms

• Loss of sensation in the legs and feet.
• Increased risk of skin sores and skin infections.
• Hydrocephalus, which is the buildup of cerebrospinal fluid in the brain, which can potentially lead to enlargement of the head, developmental issues and learning disabilities in some cases.

Spina Bifida and Latex Allergy

People with spina bifida are at increased risk of being allergic to naturally-derived latex. A latex allergy can cause a range of issues, including rashes, itching, sneezing, cough and shortness of breath. In severe cases, a latex allergy can even cause a dangerous condition called anaphylactic shock (also called anaphylaxis), which should be treated as a medical emergency.

In addition to making people with spina bifida more likely to experience an allergic reaction in a health care setting, where items like latex gloves, tubing and catheters are common, a latex allergy can also potentially be triggered by certain foods that have proteins similar to those found in natural rubber tree sap.

Foods considered highly latex-reactive include avocados, bananas, kiwi fruits and chestnuts, though other foods — including apples, carrots, tomatoes and potatoes — also carry a moderate risk of latex reaction.

Visit here to learn more about spina bifida and latex allergy from the Spina Bifida Association.

What Are the Risk Factors for Giving Birth to a Child With Spina Bifida?

The true root cause of spina bifida is unknown. However, there are certain factors that are known or suspected to increase a woman’s risk of having a baby with the condition. These factors include:

• Low folic acid intake before or during pregnancy: Folic acid (the natural form of vitamin B-9) plays an important role in normal neural tube development. Not getting enough folic acid before pregnancy and in the early weeks of gestation can significantly increase the risk of having a child with spina bifida.
• Family history: One parent having a close family member with spina bifida or other types of neural tube defects increases the risk that their baby will have the condition.
• Certain medications: Taking certain medications during pregnancy, including the anti-seizure medication valproic acid (used for seizures), has been linked to an increased risk of spina bifida.
• Being obese during pregnancy: While the link is complex, studies suggest women with a higher body mass index (BMI) during pregnancy can increase the risk of having a child with spina bifida.
• Having diabetes: Women with both pre-existing and gestational diabetes are at elevated risk.
• Certain environmental factors: Some research suggests that women who are exposed to certain chemicals or pollutants before or during their pregnancy have an increased risk of having a child with spina bifida.

Is There Any Way to Reduce a Person’s Risk of Having a Child With Spina Bifida?

Because the true cause of most cases of spina bifida is unknown, there’s no known way of definitely preventing a person from having a child with the condition. However, there are certain steps you can take to potentially lower your risk factors.

These include:

• Take a daily folic acid supplement before and during pregnancy.
• Eat plenty of folate-rich foods if you might become pregnant.
• Maintain a healthy weight through regular exercise and a diet that’s low in sugar and fat, both to avoid obesity and diabetes.
• If you have a family history of spina bifida or other neural tube defects, talk to your doctor about the risk of having a child with spina bifida before you become pregnant.

Looking for an Adult Spina Bifida Specialist? In Orange County, Hoag Is Your Home For Advanced Care for the Spine.

Every day at the Hoag Spine Institute, our world-class team of spine specialists, diagnostic experts and spinal surgeons is united in one mission: providing the best, most patient-focused care for those dealing with spine issues in Orange County.

Our commitment for older teens and adults with neural tube defects like spina bifida and other birth defects that can impact the spine is particularly strong. Through education, the latest techniques, next-generation technology and a dedication to putting patients first, the Hoag Spine Institute is helping medicine make great strides toward a day when no person has to deal with the often-debilitating effects of spina bifida.

Are you searching for an adult spina bifida specialist in Orange County? Then you owe it to yourself to seek out the team with the compassion and technology to build a treatment plan that’s just for you.

To learn more about Hoag Spine Institute, or to schedule a comprehensive diagnostic evaluation with a Hoag spine care specialist, please contact us today at 949-764-1411 or through our online form.