I was eight years old,the first amongst three children when my mother informed us we would be having a baby brother soon.I can’t recall how elated and excited I was.Fast forward to the day he was born,my joy knew no bounds. I assisted my mother in taking care of him and I also spent a lot of time with him too.
But then, I noticed that he had an opening at his lower back which in later months to come,didn’t allow him to sit up when babies do,crawl and even start walking.I shared the pain with my parents when I saw how other babies were growing. At eleven months,he began to have complications especially with hydrocephalus, which later led to his death. The grief was unbearable.

WHAT IS SPINA BIFIDA?
Spina bifida is a neural tube birth defect which results to a cleft in the spinal column through which the spinal membrane and spinal cord may protrude. As such,the spine ends up not forming normally.

FACTS ABOUT SPIDA BIFIDA
It is also called Split Spine
It is characterised by other neurological disorders like hydrocephalus.
Treatment can help,but as a congenital (birth) defect it cannot be completely cured.

HOW IS SPINA BIFIDA FORMED?
Asides from genetic and environmental factors playing a role,lack of folic acid intake has been linked to be the major cause of spina bifida.As essential as folic acid and Vit B 12 is for prenatal care,it helps in forming the neural tube that eventually becomes the spinal cord and thus helps to prevent neural tube irregularities. When the required amount of folic acid needed by the fetus is not gotten, the neural tube might not close completely, and sina bifida as well as anencephaly could result.

TYPES OF SPINA BIFIDA
SPINA BIFIDA OCCULTA:This type of spina bifida is not so serious as it might even go unnoticed, here,the spinal cord does not stick out through the layers of the skin and may not result to long term health issues.

SPINA BIFIDA APERTA
This has two subtypes
1. MENINGOCOELE: The meninges protrude through either the skull or vertebrae and forms a fluid-filled sac which can be seen either at the back or back of the head.This condition usually comes with a lot of health problems such as bladder malfunctioning.

2. MYELOMENINGOCOELE: Part of the spinal cord and surrounding nerves protrude through the open vertebrae and is seen at the fetus back.

SYMPTOMS OF SPINA BIFIDA
The myelomeningocoele lesion can occur at any level in the developing spine,but majorly occurs in the lumbosacral region.The higher the defect,the more serious the complications.Clinical features include
Lower limb paralysis
Bladder and bowel malfunction(Incontinence)
Club feet
Sexual dysfunction
Other cognitive impairments

COMPLICATIONS OF SPINA BIFIDA
1. HYDROCEPHALUS: This is a condition which is congenital where there is abnormal accumulation of fluid in the brain, resulting to enlargement of the skull,compressing the brain and destroying much neural tissue.This occurs when there is herniation of the hindbrain which blocks circulation of cerebrospinal fluid and causes hydrocephalus.

2. ANENCEPHALY: Due to the herniation, especially when these neural tissues are formed,most parts if the brain and skull becomes missing and there could be absence of neural tissue.
Other complications include Scoliosis and kyphosis.

TREATMENT
Treatment for spina bifida involves surgery, and this depends on the severity. The type of spina bifida indicates whether it will be fetal surgery during pregnancy or post natal surgery after birth.Other treatments may focus on managing complications.

1. FETAL SURGERY: Babies with myelomeningocoele may need surgery during the 25th-26th week of pregnancy to reduce the disability that may occur after birth.If it cannot be done during pregnancy, then a surgery on the 1st or 2nd day after birth can also be effective in doing this.This requires a team of fetal experts.
2. POST-NATAL SURGERY: Babies born with meningocoele and also myelomeningocoele require surgery after birth to reduce the effect that could be caused by it.
3. SURGERY FOR HYDROCEPHALUS: To treat the hydrocephalus which comes as a complication shunts are being passed to drain fluid from the brain into the peritoneum (abdomen).

PREVENTION OF SPINA BIFIDA
During pregnancy, it is best prevented by taking at least 400 mcg of folic acid every day.Research has proven that folic acid along with Vit B 12 taken during pregnancy will reduce the risk of neural tube defects especially spina bifida by 70%.