There are potentially many different causes of spina bifida and neural tube defects including both genetic and maternal.
A clinically great breakthrough for maternally derived neural tube defects was the discovery of a relationship between low dietry folate and an increased occurance of neural tube defects. See also Neural Tube Defects and low maternal folic acid in section below.
The main objective in using Spina Bifida as a teaching model is to stress the main features in an integrated approach to the total care of the Spina Bifida patient.
See also: Folate | Neural Abnormalities notes
There are 4 main types of Spina Bifida involving to differing degrees the neural, miningeal, skeletal systems.
Myeloschisis
Neural groove open at one or several thoracolumbar levels, leading to paralysis.
Myelomeningocele (Spina Bifida Cystica)
Dome-shaped cyst frequently at the lumbar level. Cyst can contain neural, leptomeninges and glial tissues.
Meningocele
Cyst containing only meninges with intact neural tube with possible some neural abnormalities.
Spina Bifida Occulta
Vertebral arches unfused and underdeveloped, vertebral canal is open but meninges and spinal cord in canal.
Site is covered with skin and in some cases (20-25%) symptomless, others involve peripheral nerve and lower limb abnormalities.
(a) Describe the possible processes involved in the abnormal development of the C.N.S. in Spina Bifida. At what time in development would these abnormal events occur?
(b) What is amniocentesis? Would this procedure be useful in the diagnosis of Spina Bifida? Give reasons for your answer.
(c) What is the effect of the lesion on the bladder, bowel and limbs? Describe the differences on these areas between lesions at the following levels:
a. Cervical
b. Thoraco-Lumbar
c. Sacral
(d) If the lesion is at higher thoracic levels, why would the prognosis for the patient be poor?
(e) Compare and contrast the following:
(i) Transection
Search Pubmed Now:Spina Bifida [Title]
Recent Folate Articles
DESCRIPTION: Spina bifida (SB) is a neural tube defect (a disorder involving incomplete development of the brain, spinal cord, and/or their protective coverings) caused by the failure of the fetus's spine to close properly during the first month of pregnancy. Infants born with SB sometimes have an open lesion on their spine where significant damage to the nerves and spinal cord has occurred. Although the spinal opening can be surgically repaired shortly after birth, the nerve damage is permanent, resulting in varying degrees of paralysis of the lower limbs. Even when there is no lesion present there may be improperly formed or missing vertebrae and accompanying nerve damage. In addition to physical and mobility difficulties, most individuals have some form of learning disability. The three most common types of SB are: myelomeningocele, the severest form, in which the spinal cord and its protective covering (the meninges) protrude from an opening in the spine; meningocele in which the spinal cord develops normally but the meninges protrude from a spinal opening; and occulta, the mildest form, in which one or more vertebrae are malformed and covered by a layer of skin. SB may also cause bowel and bladder complications, and many children with SB have hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain).
TREATMENT: There is no cure for SB because the nerve tissue cannot be replaced or repaired. Treatment for the variety of effects of SB may include surgery, medication, and physiotherapy. Many individuals with SB will need assistive devices such as braces, crutches, or wheelchairs. Ongoing therapy, medical care, and/or surgical treatments may be necessary to prevent and manage complications throughout the individual's life. Surgery to close the newborn's spinal opening is generally performed within 24 hours after birth to minimize the risk of infection and to preserve existing function in the spinal cord.
This Information from National Institutes of Health, Bethesda, Maryland 20892, USA
See also NIH Spina Bifida dataA | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z
Relate to lifestyle, environment and nutrition. An example of this form of abnormality is the impact of inadequate dietry folate intake (neural tube defects).
You should look at normal development. Development Notes
Alternatively, go on to look at Systematic Development of organs and tissues.
For those wanting to see dynamic processes of development (and have a reasonably quick connection) then the Movies pages are good for watching changes occur.
The study of human development has relied extensively on studying the process in other model animals. For those wanting to see the process of development in other species then the other embryos pages are a good start.
Home Page
Embryo stages
Fetal Dev
Dev Notes 1
Dev Notes 2
System Notes
Acknowledgements
Movies
Audio
Class Notes
Serial Images
K12 Students
Abnormal Development
Embryology in the News
Histology
Site Map
School of Med Sci
UNSW Medicine
University of NSW
UNSW Cell Biology
NCBI Books
Dev Biol (Gilbert)
How and why do things go wrong in development?
Abnormalities in human development can be due to many different factors, this page gives a few starting points to look at the topic of spina bifida.
This initially neurological abnormality, due to failure of the neural tube to close, can not only have an impact on neural but also musculoskeletal development of the axial skeleton.
Please email Dr Mark Hill if you wish to make a comment about this current project.