Spina Bifida

• Neural tube defect

• failure of fusion of vertebral arches and development of posterior dura mater

• most commonly in lumbo-sacral region

Variations

• spina bifida occulta

  • defect in vertebral arch can only be noted by palpation although may be indicated by patch of hair at base of spine

• menigocoele

  • herniation of pia-arachnoid may be covered by skin

  • if neural tissue not involved then surgical closure may allow normal development

• meningmyelocoele

  • cord displaced as well as membranes

  • skin cover incomplete

  • hydrocephalus and paralysis of legs, bowel and bladder normally present

  • if not closed within 24 hours, infection likely

• Myelocoele

  • cord opened out

  • prognosis same as meningomyelocoele

Prevention

• folic acid supplements before conception

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