Spina Bifida Treatment Cost in India

Last Modified: June 7, 2023  |   Created on: May 1, 2023
Spine

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One of the most beautiful things in the world is childbirth. The blessing of a healthy child is priceless. The health of the unborn child and the child after birth can be impacted by a wide range of illnesses and disorders.

Spina bifida is one of them, it’s a birth defect brought on by improper spinal cord and spine development.

  • Spina Bifida is a common birth defect that is also associated with neutral tube defects.
  • The neural tube typically develops early in pregnancy and closes on the 28th day following conception.
  • Spina bifida is a condition where a portion of the neural tube fails to close or develop normally, leading to problems with the spinal cord and the spine’s bones.
  • It leaves a split or gap, harming the nervous system. Spina bifida is the term for this defect.
  • Children with spina bifida experience no issues as a result of their condition.
  • With this condition, it is difficult to walk independently or perform daily tasks.
  • This birth defect is present in 1-2 out of every 1000 live births. Spina bifida develops during the foetus’ in-utero development.
  • Depending on the severity, size, location, and complications of the defect, spina bifida can range from mild to serious.
  • Surgery is sometimes used as part of early treatment for spina bifida, though it isn’t always effective in curing the condition.

Spina Bifida physical symptoms can include:

  • Leg paralysis and weakness
  • Orthopaedic anomalies, such as scoliosis, hip dislocation, and club feet
  • Bladder and bowel control issues, such as incontinence, UTIs, and impaired kidney function
  • Skin rashes and pressure sores
  • Inconsistent eye movement

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Types

Spina bifida occulta and spina bifida manifesta are the two main types of this condition.

  • Spina bifida occulta is the most prevalent and mildest type.
  • The spinal defect is concealed beneath the skin and typically does not require treatment.
  • According to medical professionals, this spinal defect is unknowingly present in 10% to 24% of the general population.
  • In some instances, the skin over the affected vertebrae develops a birthmark, dimple, depression, or hairy patch.
  • The term “occult spinal dysraphism” (OSD) is used to describe this.
  • Spina bifida manifesta is the severe but uncommon variety of this birth defect.
  • It frequently entails nerve damage, which can lead to issues with coordination, walking, and bladder control.
  • Meningocele and myelomeningocele are two categories into which it can further be subdivided:
  • Meningocele is a condition where fluid leaks from the spinal canal, resulting in an enlarged region over the baby’s spine.
  • Having meningoceles may result in issues with bowel and bladder function.

In myelomeningocele, a spinal nerve root protrudes against the skin’s underside from the spinal canal. The nerves are frequently harmed.

  • The nerves are exposed to the outside of the body when the skin is open, which is the worst scenario. Several lower back vertebrae still have the spinal canal exposed.
  • Although it’s only occasionally that skin covers the sac, and the tissues and nerves are visible.
  • At birth, the membranes and spinal cord or nerves both protrude, creating a sac.
  • Due to a defect at the base of the skull (Chiari malformation), hydrocephalus affects between 70% and 90% of newborns with myelomeningocele.
  • If left untreated, hydrocephalus, which is an excessive build-up of spinal fluid on the brain, will result in brain damage, seizures, or blindness.
  • To prevent this, plastic shunts that drain extra fluid into the abdominal cavity must be surgically implanted beneath the skin.

Adult Spina Bifida

Spina bifida affects adults differently than it does children. For example, adults with SB typically age more quickly or more severely, which results in a loss of muscle strength and adaptability, decreased physical stamina, and a decline in sensory abilities.

Spina bifida affects adults differently than it does kids, including:

  • For adults with SB, the natural ageing process, which includes muscle loss, decreased physical stamina, and a decline in sensory abilities, tends to deteriorate more quickly or severely.
  • Loss of sensation, pain (especially in the lower extremities or testicles), skin sores, rapidly progressing scoliosis, urinary tract infections, and leakage are all signs of spinal cord tethering, where the spinal cord becomes attached to the surrounding tissue.
  • Alterations in bowel habits, such as constipation or abdominal pain.
  • Osteoporosis, early-onset arthritis, and escalating back pain are orthopaedic problems.
  • The inability to sweat, poor circulation, bruising, and a slow rate of wound healing, as well as the loss of skin sensation.
  • Latex sensitivity
  • Elevated blood pressure
  • Obstructive and central sleep apnoea, which can cause permanent heart damage.
  • Obesity is prevalent in adults with spina bifida.
  • Spina bifida can complicate pregnancy for some women, but it is possible for these women to become pregnant.
  • The majority of symptoms and disabilities are understood by adulthood.
  • Normally, coping strategies, medications, therapies, and any necessary walking aids are in place.
  • Many spina bifida patients grow up to go to college and have successful careers. Some people also live on their own.

Causes of Spina Bifida

Although Spina Bifida’s exact cause is unknown, doctors think that both genetic and environmental factors may be at play.

Babies born to women whose ancestors originated in the British Isles are more likely to have spina bifida manifesta than other babies.

Babies whose mothers were born in Africa are much less likely to experience it.

Women who have already had a child with spina bifida are more likely to have another one. Other elements that could raise the possibility of having a child with spina bifida include:

  • Deficiency of folic acid (vitamin B-9)
  • Taking particular medications, such as those prescribed for epilepsy or acne.
  • Excessive alcohol consumption.
  • The exposure to specific chemicals.
  • Exposure to a hot environment.
  • A diabetes diagnosis (Uncontrolled diabetes in the mother)
  • Nearly 90% of spina bifida cases have no prior history of the condition. However, there are higher chances that another child will be born with spina bifida when a woman gives birth to one.
  • High fever in the early stages of pregnancy.
  • Obesity.

Symptoms of spina bifida

  • Spina bifida symptoms vary depending on how severe the condition is. There might be no symptoms at all in spina bifida occulta or just a dimple, depression, birthmark, or hairy patch over the affected vertebrae.
  • There will be a sac-like mass of the spinal cord and nerves protruding from the back. A portion of the spinal cord, meninges, and nerves are all included in this mass. Babies with this condition will have an open spinal defect that requires immediate surgery to close the skin and protect the spinal cord and nerves.
  • There may be swelling over the affected spine in spina bifida manifesta. The child may have issues with coordination, walking, and bladder control if the nerves are damaged which results in bowel incontinence and urinary incontinence
  • Leg paralysis and numbness are more likely to occur in the legs of the child than in the arms.
  • Many newborns will either have or develop hydrocephalus, a fluid build-up on the brain that can worsen existing brain damage.
  • The majority of spina bifida sufferers are intelligent, but some experience learning challenges.

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Treatment

Spina bifida has no known treatment. It is impossible to restore function to the damaged nerves or to repair the damaged nerve tissue.

  • The type and severity of the disorder determine the course of treatment. Most kids with the mildest form don’t need any treatment, though some might as they get older need surgery.
  • The severity of spina bifida affects the course of treatment. Surgery may be performed to fix the spinal defect or to address side effects like hydrocephalus. Children with issues brought on by nerve damage may require physical therapy, braces, and other treatments.
  • Preventing infection from spreading to the exposed nerves and tissue through the spinal defect and shielding the exposed nerves and structures from further trauma are the two main early treatment priorities for myelomeningocele.

The following is a list of the various treatment options:

Prenatal Surgery

  • Prior to the 26th week of pregnancy, this prenatal surgery is performed. The uterus of the pregnant woman is surgically opened, the uterus is exposed, and the baby’s neural structure is repaired.
  • With a specialised surgical instrument (fetoscope) inserted into the uterus, this procedure is frequently carried out less invasively on a small percentage of patients.

Caesarean Section

  • Babies with myelomeningocele frequently have a breech (feet first) position. Caesarean birth might be a safer delivery option if the baby is in this position or if the doctor notices a large cyst or sac.

Postnatal Surgery

  • Within 72 hours of birth, a baby with myelomeningocele needs surgery to close the opening in their back. Early surgery can reduce the risk of infection associated with the exposed nerves.

Other treatment options may include:

  • Orthopaedic surgery: Leg and foot operations can help children move around more easily.
  • Bladder surgery: This procedure enlarges the bladder as well as tightens the muscles in the abdomen.
  • Surgery: Surgery is performed to close the lesion and lower the risk of infection.
  • Diet and enemas: Diet and enemas are two methods used to treat faecal incontinence.
  • Aids: Wheelchairs or walking aids are used as assistance.
    General Measures: It is necessary to regularly monitor the functions of the kidneys, spine, and bladder.
  • Self-catheterization and continence pads: Managing urinary incontinence is crucial. Bags for faeces or urine may become necessary.

What are the chances of having a spina bifida child?

  • A 10% chance of having another spina bifida child exists for parents of two spina bifida children.
  • There is a 4% chance that if one parent has spina bifida, their child will also have it.
  • Certain medicines: For instance, anti-seizure drugs like valproic acid (Depakene), when taken during pregnancy, appear to result in neural tube defects. They may prevent the body from using folic acid and folate, which could explain why this occurs.
  • Diabetes: A baby born to a diabetic mother who has poorly controlled blood sugar is more likely to have spina bifida.
  • Obesity: Obesity before becoming pregnant raises the risk of birth defects of the neural tube, such as spina bifida.
  • Higher body temperature: According to some research, hyperthermia, or elevated body temperature, during the first few weeks of pregnancy may increase the risk of spina bifida.
  • The risk of spina bifida has been linked to increasing your core body temperature, whether from a fever or from using a hot tub or sauna.

How long can someone with spina bifida expect to live? What’s the success rate?

  • The outlook for those who had the most severe neurological deficits was startlingly poor. Compared to 61% of people with low sensory levels, only 17% of people born with high sensory levels reached the average age of 40 years.

Compared to 80% in the group that underwent traditional surgery, infants who underwent surgery before birth had a 93% chance of being able to walk unassisted by the time they reached school age.

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