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Spina Bifida

Spina bifida is a congenital disorder resulting from the incomplete closure of the embryonic neural tube, leading to various types such as occulta and cystica. Symptoms can range from asymptomatic cases to severe complications like paralysis and hydrocephalus, with diagnosis typically involving imaging techniques and maternal serum tests. Management varies based on the type, with surgical intervention often required for cystica, and prevention strategies include folic acid supplementation and genetic counseling.

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Muazzam Ali
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7 views26 pages

Spina Bifida

Spina bifida is a congenital disorder resulting from the incomplete closure of the embryonic neural tube, leading to various types such as occulta and cystica. Symptoms can range from asymptomatic cases to severe complications like paralysis and hydrocephalus, with diagnosis typically involving imaging techniques and maternal serum tests. Management varies based on the type, with surgical intervention often required for cystica, and prevention strategies include folic acid supplementation and genetic counseling.

Uploaded by

Muazzam Ali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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A PRESENTATION ON

SPINA BIFIDA
OBJECTIVES

 Definition of Spina Bifida


 Anatomy
 Causes
 Pathophysiology
 Types of Spina Bifida
 Signs and Symptoms of Spina Bifida
 Complications
 Diagnosis
 Management of Spina Bifida
 Nursing Management
 Prevention
What is Spina Bifida?

 Spina bifida is a developmental congenital disorder caused by the


incomplete closing of the embryonic neural tube.
 Some vertebrae overlying the spinal cord are not fully formed and
remain unfused and open.
 If the opening is large enough, this allows a portion of the spinal cord
to protrude through the opening in the bones.
 There may or may not be a fluid filled sac surrounding the spinal
cord.
ANATOMY

 Normal anatomy of spine divided into 3 major section - the cervical ,the
thoracic,and lumbar spine
 Each sections made up of individual bones called vertebrae ,12 thoracic
vertebrae,5 lumbar vertebrae and 7 cervical vertebrae
 The body of vertebrae is primary area of weight bearing and provides a
resting place for fibrous discs
 The lamina covers spinal canal which is large hole in center of vertebrates
through which spinal nerves pass
 The vertebrates are separated by intervertebral discs
Main Causes of Spina Bifida

 Maternal diabetes
 Family history
 Obesity
 Genetic Basis
 Folic acid deficiency
 Medications such as some anticonvulsants.
PATHOPHYSIOLOG
Y
Spina bifida occurs when local
regions of the neural tube fail to
fuse or there is failure in
formation of the vertebral neural
arches.
Neural arch formation occurs in
the first month of embryonic
development.
Classification of Spina Bifida

SPINA BIFIDA

SPINA BIFIDA SPINA BIFIDA


CYSTICA OCCULTA

MYELOMENINGOC
MENINGOCELE
ELE
SPINAL BIFIDA
OCCULTA

 Its is a defect which result from


failure of formation of bony
arch around the spinal cord,
but the spinal cord and
meninges are normal.
 It is not visible externally and
is asymptomatic.
 There is gap in one or more of
the vertebra of the spine.
 No treatment is needed.
SPINA BIFIDA
CYSTICA
 It is a defect in the
closure of posterior
vertebral arch with
protrusion of spinal cord
and meninges through
the defect
 Meningocele is a sac like
herniation through the
bony malformation,
containing meninges and
cerebrospinal fluid.
 Myelomeningocele is sac
like protrusion of spinal
cord , CSF and meninges
through spinal cleft. It is
mostly found in lumbar or
lumbosacral region.
Signs and Symptoms of Spina
Bifida
SPINA BIFIDA OCCULTA SPINA BIFIDA CYSTICA
It is asymptomatic and the only  Meningocele
features visible are 1. External cystic defect
1. Dimple in the skin 2. Weakness of leg or lack of
2. Growth of hair over sphincter control
malformed vertebrae  Myelomeningocele
3. Development of foot 1. Hydrocephalus
weakness or disturbances of
2. Loss of motor control
bladder while growth
3. Congenital skeletal anomalies
4. Herniated mass in lumbosacral
region
COMPLICATIONS

 Frequent urinary tract infection


 Hydrocephalus
 Loss of bladder and bowel control
 Meningitis
 Permanent weakness or paralysis of legs
DIAGNOSIS

 Ultrasound
 Fetal MRI
 Amniocentesis
 CT scan and MRI of Spinal cord
 Maternal serum alpha _ fetoprotein (MSAFP) Test
 Test to confirm high AFP levels
Fig: ct scan of spinabifida Fig : x ray of spina bifida
oculata
Fig: Ultrasound
imaging
MANAGEMENT
OF SPINA BIFIDA
 It depends on the nature and
extent of defect. Usually no
intervention is required for
Spina bifida occulta
 For Spina bifida cystica
surgery is required
(laminectomy) and closure of
the defect is done within 24-
48 hours of birth.
NURSING MANAGEMENT

Pre _op
1) Position the child in prone with legs abducted
2)Put the child in incubator or warmer area without clothes
3) Apply dressing to avoid drying of the area due to heat in incubator
4) strictly use sterile gauze so as to prevent re _ infection
5)chnge dressing two four hourly to avoid drying
6)Use normal saline or silver nitrate in dressing
7)Gentle handling of the child to avoid risk of trauma
8) Change the child postion every two hours , to promote
circulation and prevent development of decubitus sore
9)check vital signs and signs signs of increased
intracranial pressure
10) Asses for signs of hydrocephalus
11) Cover the sacrum with sterile surgical drape
12 ) Measure head circumference
13) Prepare mother psycholoogicallly
14)Apply gentle pressure to suprapubic area to facilitates
urine emptying
15) Psychologically care the mother
16) Observe for leakage
17) Maintain passive range of motion of extremities
18) Give high Fibre diet to child
19) To alley anxiety ,counsel the mother on condition of
child
20) Teach parents to observe for signs of complications
21) Teach the care of the child
POST_ OP
1) Position the child in prone to avoid pressure on suture
or side lying position alternatively
2) Monitor the child vital signs every 30 minutes
3) Use all measures to avoid any infection
4) Monitor input and output
5) Encourage the monitor to continue breastfeeding if
the child is being breastfed
6)Resume feeding after effects of anesthesia
7)Resume dressing after 48 hours to check any signs of
bleeding or bulging
PREVENTION

 Genetic counseling of at risk couple may be recommended.


 If severe defect is detected early in pregnancy therapeutic abortion
may be considered.
 Folic acid supplements.
THANK YOU FOR
YOUR ATTENTION
 What is Spinda Bifida?
 A.
 Birth Defect involving backbone and spinal canal
 B.
 Related to Herpes Zoster
 C.
 Skin Disorder

 Some symptoms of spinda Bifida/spinal injury include:
 A.
 Loss or no bowel and bladder control
 B.
 Partial or complete paralysis
 C.
 Weakness of hips, legs and feet
 D.
 All of the above
 There are 3 different types of Spina Bifida.
 A.
 True
 B.
 False

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