SPINA BIFIDA

Exposed spinal cord disease

Spina Bifida is a congenital opening of the spinal canal. The spinal canal is open because an embryonic ancestor (the neural tube) didn’t close properly, which is usually attributed to a folic acid deficiency in mom. It usually affects the lumbar spine. 

Different kinds of Spina Bifida?

There is a spectrum. See image below. The mildest is Spina Bifida Occulta, the most severe is the myelomeningocele. Only the myelomeningocele causes serious nerve problems because the spinal cord can get squished as it herniates out of the spinal canal. It can produce symptoms similar to conus medullaris syndrome (incontinence, leg paralysis). 

Diagnosis?

There will be elevated alpha-fetoprotein in the amniotic fluid and maternal blood. Acetylcholinesterase also tends to be elevated. In spina bifida occulta there is actually normal AFP.

Prevention?

Prenatal vitamins containing folic acid. Pregnant individuals should avoid folic acid-blocking drugs like antiepileptics or TMP-SMX.