Spina Bifida: Congenital Disability at Birth - Research Paper

Introduction

Spina bifida refers to a defect that arises in spine development due to the lack of tissue and skin that covers the spinal cord. Spina bifida is among a group of defects at birth known as neural tube defects. The ailment is present at birth and is a congenital disability characterized by problems with the spinal cord, spine and even the surrounding nerves. In the fourth week of pregnancy, the neural tube in a normal case closes; however, for spina bifida, these neural tubes fail to close fully leaving a baby's delicate spine without the much-needed protection; hence, it becomes open to harm or a possible injury. The neural tube defect comes out as the most serious and common defects at birth. The highest cases of Spinal Bifida at about 85% affect the lower back part majorly, and 15% affects the upper back area. In children, Spina bifida can occur at any point along the spine. In the US the neural tube defects occur in about 7 in 10,000 live births. The paper shall provide extensive details with regards to Spina bifida in young children.

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Three Types of Spina Bifida

Myelomeningocele. This is the most acute kind, and it involves the spinal canal remaining open, in this case, along a number of vertebrae located in the middle and lower back.

Meningocele. This is the moderate kind, and it involves a spinal cord part and nerves forming outside a patient's body.

Spina Bifida Occulta. The disorder is the mildest and leads into a small opening or separation in one or even more spinal bones identified as vertebrae. The condition may affect people, but they may not be aware of it.

Signs and Symptoms

The symptoms vary from a child to another they can include, the area at the back appearing abnormal; for instance, having a small hairy patch, pouch-like bulge or birthmark. Secondly, Lack of a feeling at the position of the sac below the spine. Thirdly, the paralysis that can be characterized by the inability to move legs. Fourthly, the problem of constipation. Fifthly, bone problems. Sixthly, heart-related complications. Seventhly, low intelligence level, and hydrocephalus.

Causes

Spina bifida can be as a result of genes getting passed from both of the parents. The condition can be caused by environmental factors such as uncontrolled diabetes in a mother or obesity and by prescription medication (Long, 2018). The doctors are not certain about Spina bifida causes; therefore, it appears to be due to a combination of environmental and genetic factors.

Diagnosis

Spina bifida diagnosis in children requires specific tests, and a mother may require to undergo tests while pregnant to examine the growing baby. Open neural tube deformation is diagnosed prenatally. The defects that are not diagnosed by maternal blood work and prenatal sonogram are diagnosed through a physical examination after birth.

First of all, a blood test. The test is known as a quad screen checks for four substances in a mother's blood to identify whether there is a high risk for neural tube deformation and other problems. The test gets carried out at around 16 to 18 pregnancy weeks. The test checks for alpha-fetoprotein and any other elements in the blood. Alpha-fetoprotein refers to a protein that is made by a baby growing in a mother's womb. A baby that has spina bifida in the test will have the alpha-fetoprotein levels being higher than normal. However, the test by itself is not conclusive, but it can provide insights into whether the baby is at risk of spina bifida.

Secondly, prenatal ultrasound test. The imaging test makes use of sound waves that of high-frequency and with the aid of a computer to present the images of organs, tissues, and blood vessels. The ultrasounds give healthcare practitioners the ability to observe internal organs and their functioning. The ultrasound will also show the blood flowing through the blood vessels. The test may enable a health practitioner to identify a spina bifida defect in a fetus.

Thirdly, Amniocentesis. The test involves taking a small sample through the use of a long and thin needle of fluid surrounding a baby in the womb. The fluid sample is then checked for alpha-fetoprotein. The test's limitation is it may not find close or small defects.

Prevention

A woman planning to get pregnant can take folic acid in supplement form before getting pregnant at least one month and continuing throughout the pregnancy's first trimester. Folic acid greatly minimizes Spina Bifida's risk together with other defects associated with the neural tube.

Treatment

Spina Bifida remedy hinges on several factors, particularly the disorder's severity.

Surgical Treatment

First of all, the surgery to repair a child's spine which can be done at birth within two days. The treatment involves the surgeon replacing any exposed nerves or tissues and the spinal cord into the body of the newborn baby. The existing gap, in this case, in the vertebrae gets closed, and then the spinal cord will be restored with both muscle and skin.

Secondly, prenatal surgery involves the surgeon opening the uterus through a surgery and then repair a fetus spinal cord at about 19 to 25 weeks during a pregnancy (Mitchell et al., 2004). The surgery can be recommended to minimize the Spina Bifida worsening risk after delivery.

Thirdly, hydrocephalus surgery to treat the buildup in the brain of cerebrospinal fluid. A surgeon imbeds a shunt in a patient's brain and then after the implant it serves to drain the excess fluid that is common to the abdomen. Further surgery may be required when the shunt becomes infected or blocked with a permanent one being necessary.

Fourthly, birth through caesarian-section when a fetus has spina-bifida because it is more safe for the patient's exposed nerves.

Physical and Occupational Treatment

To begin with, the physical therapy remains critical because it assists a patient to learn to be more independent and even prevents the weakening of lower limb muscles. The special leg braces can assist in keeping strong muscles.

Secondly, the assistive technologies for patients who have total leg paralysis and who require a wheelchair. The electric wheelchairs are suitable; however, the manual ones assist in maintaining general fitness and upper body strength. Computers and other specialized software can assist children who undergo learning problems.

Thirdly, Occupational therapy that involves assisting a child in performing his or her daily activities even more effectively, for instance, dressing. The therapy assist in building on independence and in encouraging self-esteem.

Urinary Incontinence Treatment

The treatment will have a urologist assessing a Spina bifida child. The first treatment is through anticholinergic with these drugs prescribed mainly for maturing kids and they aid in increasing the levels of urine that a bladder can hold as well as reduce the frequency of passing out urine.

Secondly, the treatment through clean intermittent catheterization which is a technique used at regular intervals to empty a child's bladder (De Jong, Chrzan, Klijn & Dik, 2008). A parent or the ailing child learn how to place a catheter via the urethra into the bladder.

Thirdly, Botox injection which is given to a child whose bladder abnormally contracts to paralyze these muscles and when it works the treatment is provided for every six months.

Long-term antibiotics usage remains necessary to prevent kidney and urinary tract infections.

Bowel Incontinence Treatment

The treatment requires a special diet and toilet training techniques, while other options may require surgery. To begin with is a diet in Spina Bifida children should be balanced and healthy with sufficient amounts of fiber to prevent constipation. Secondly, anal plugs placed into the anus in the ailing children to prevent them from soiling. Thirdly, enema for children who may not have positively responded to treatment to clean out in two or three days the bowel. Other kinds of treatment are also advised depending on the condition.

Complications

The Spina bifida complication in the young children ailing from the disease varies depending on the severity of the condition and the affected body system. A young child may experience problems in their bones, muscle functioning, bladder, and bowel emptying. The young children who suffer from Spina Bifida will have a high risk when it comes to developing an allergic reaction against latex. The complication arises because the young children get exposed to latex in the course of the many surgical and medical procedures that they need. The healthcare practitioners, however, do their best to minimize the amount of latex exposure to a child.

The children may have mobility or walking problems. The problem may arise when the nerves that are supposed to control the muscles in the legs fail to work normally below the point at which the deformation has occurred, leading to legs muscle weakness that at times involves paralysis.

Orthopedic complications, particularly, in children suffering from myelomeningocele who may experience different problems in the spine and legs as a result of weak muscles at the back and legs. Possible complications may include dislocation of a hip, abnormal growth, and a curved spine.

Other complications include Hydrocephalus which is the fluid accumulation in the brain with babies affected by myelomeningocele experience problems as a result of it. Skin problems because the children who suffer from Spina Bifida can get wounds on buttocks, feet, legs or back. As the young children continue to advance with age may experience depression, gastrointestinal disorders, and urinary tract ailments.

How to Encourage Young Children's Independence

The preschoolers and toddlers who suffer from Spina bifida have many ways that caregivers, parents or teachers can assist them to be more independent and active. Young children will need to understand their bodies and spina bifida. The second thing is that the children will be encouraged to make choices, for instance, between clothing. The affected children also may be asked for help in simple things, for instance, putting toys away.

The children will require extra assistance on certain occasions, but the essential thing is allowing the young children every opportunity to try to complete a particular task before intervening. The caregivers, teachers, and parents should give the children a chance to try and only offer help when it is required. Caregivers and parents should know the right balance between offering the right level of assistance to significantly increase a child's independence and confidence.

• Problems Teachers Should Be Aware of When They Accommodate Spina Bifida Children
• Bladder and bowel control complications
• Bad eye-hand coordination that can make handwriting more difficult
• Hydrocephalus that involves the buildup of fluid around and in a child's brain that needs a shunt to be able to drain this excess fluid. Teachers and other caregivers should be mindful of the symptoms
• Learning problems such as ADHD.
• Paralysis that depends on the defect and the opening's location.

Accommodations Young Spina Bifida Children Need in a Classroom

To begin with, the young children may use casts, splints, canes, leg braces, walkers, wheelchairs or crutches to move around in a classroom setting and any other location. Secondly, the Spina bifida children may require more extra time to move around the classrooms and even throughout the school. Thirdly, the Spina bifida children may miss their class time as a result of the need for surgeries or medical appointments.

Fourthly, the need for special desks, seats, and tables together with more specialized assistive technology. Extra space to accommodate the wheelchair and other equipment is required. Fifthly, the children may require frequent bathroom bre...