Treatment of spina bifida

Treatment for spina bifida depends on the severity of the condition.

  • Most people with spina bifida occulta require no treatment at all.
  • Children with meningocele typically require surgical removal of the cyst and survive with little, if any, disability.
  • Children with myelomeningocele, however, require complex and often lifelong treatment and assistance. Almost all of them survive with appropriate treatment starting soon after birth. Their quality of life depends at least partially on the speed, efficiency, and comprehensiveness with which that treatment is provided.

A child born with myelomeningocele requires specialty care.

  • The child should be transferred immediately to a center where newborn surgery can be performed.
  • Treatment with antibiotics is started as soon as the myelomeningocele is recognized; this prevents infection of the spinal cord, which can be fatal.
  • The operation involves closing the opening in the spinal cord and covering the cord with muscles and skin taken from either side of the back. The most common complications are tethered spinal cord and hydrocephalus, which can have very severe consequences.

Each person with severe spina bifida requires intensive and complex care by a trained and coordinated team.

  • The care team includes one or more pediatricians, neurologists, neurosurgeons, orthopedic surgeons, physical medicine specialists, endocrinologists, urologists, physical therapists, orthotics specialists, occupational therapists, psychologists, nurses, dietitians, social workers, and other professionals.
  • If at all possible, the individual with spina bifida should receive care at a specialized multidisciplinary spina bifida clinic where all necessary services, which are extensive, can be provided in a coordinated and convenient manner.

There is no cure for spina bifida. The goal of treatment for spina bifida is to allow the individual to achieve the highest possible level of function and independence. Treatment should address any disability, physical, emotional, or educational, that interferes with that person’s potential

 

The focus of treatment is developing strength, mobility, and independence. Many of these children will walk. For others, accessibility is the goal.

  • Parents should work with a physical therapist to learn how to exercise the baby’s legs to maximize strength and movement. They should begin these exercises as soon after the first surgery as possible. This not only readies the child for walking, but also prevents osteoporosis due to disuse.
  • Children with spina bifida should be provided with prolonged physical therapy, physical education, or adaptive training while in school.
  • Many children can become mobile by wearing a brace or using crutches or an orthotic. These devices allow the child to function at the best possible level by helping with balance, posture, and control. 
  • Additional operations may be necessary to correct problems interfering with walking and other functions.
  • Despite this assistance, some children with spina bifida will never be able to walk independently. These children will use a wheelchair for the rest of their lives.

 

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~ by pcl4 on October 16, 2008.

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