What Is Spina Bifida? 

Some babies are born with a gap in their spine, a condition known as spina bifida. But how exactly will it affect them from childhood into adulthood? What kind of treatment and support will these children need to lead a good quality of life? BFM finds out from Consultant Paediatrician and Paediatric Neurologist, Dr Sofiah Ali, and Consultant Neurosurgeon Dr Azizi Abu Bakar, both from Subang Jaya Medical Centre.

Causes

"The usual causes in textbook is the lack of folic acid while lesser known risk factors include maternal diabetes mellitus, maternal obesity and some drugs taken during conception such as anti-epileptic medications. In Malaysia, we also notice a higher incidence of spina bifida in some industrial areas due to pollution from ground water," shared Dr Azizi.

Prevention

To prevent spina bifida, Dr Sofiah advises couples to plan their pregnancy, allowing women to take folic acid between 2-3 months before pregnancy and to continue taking it until 3 months of pregnancy. 

"This is because the formation of the neural tube occurs in the first 14-16 days of fetal gestation and this fetal gestation occurs 2 weeks before a woman's period. Once a women misses her period, does a pregnancy test and it turns out positive, the formation of the spinal tube is complete and it is too late to take folic acid after a positive test," Dr Azizi explains. 

Health Issues

In milder cases, the child would have a normal life and be able to walk normally. However, in moderate to severe cases, hydrocephalus (water in the brain) can cause side effects such as part of the brain being herniated. The child also experiences issues with bowel and bladder control, which is a common complication. In the long run, it affects their mobility requiring aids to walk. 

Surgery

Children with spina bifida will require an average of 4-6 surgeries from birth to 16 years old to release the spinal chord. After birth, in an open spina bifida, surgery has to be done within 24-48 hours to reduce the risk of infection and meningitis. In a closed spina bifida, surgery must happen before the baby is 12 months old. 

"Paediatricians like Dr Sofiah comes in to ensure the newborn is stable and fit to undergo surgery, and we operate in the most intricate way as the quality of the first closure secures their quality of life. Most parents assume that children with spina bifida will not be able to walk and are paralysed from the waist down as the surgery to release the spinal chord is not common. But I am proud that we are among the best in maintaining mobility. We have achieved 100% mobility for patients with closed spina bifida while for open spina bifida it depends on the level of the affected spine," Dr Azizi said. 

Listen to the full podcast here: https://www.bfm.my/content/podcast/what-is-spina-bifida