Back Pain

Spina Bifida Occulta

Spina Bifida is a developmental birth defect characterised by incomplete development of brain, spinal cord and meninges. Meninges is a protective sheath around spinal cord and brain. This is most common at S1 and L5 vertebra. Spina bifida is of 2 types-

Spina Bifida Occulta
Spina Bifida Manifesta

Causes of Spina Bifida:

Spina Bifida Occulta is a result of deformations in spinal cord, which is associated with abnormalities in spinal nerve roots. The causes for different severity of Spina Bifida Occulta are-

  • In the minor form of Spina Bifida Occulta, the bone plates that form the spinal arch fail to fuse completely. This affects one vertebra lying lowest in small of back. Since, there are no associated abnormalities of nerve roots or spinal cord, there are no bladder, bowel or leg problems.
  • In severe cases of Spina Bifida Occulta, several vertebra are fused together. This causes slightly short and stiff back. There may be an abnormal curvature of the spine. There can also be bony protrusion in the middle of back. There may be a fibrous band or bony peg at one level of spinal canal, dividing into two. Since, there is fibrous tissue or abnormal fat deposition inside the spinal canal, the spinal cord may become wide. Bladder, bowel and leg problems can occur in severe cases.

Effects of Spina Bifida Occulta:

  • Loss of Reflexes
  • Lower limb weakness
  • Numbness in legs
  • Foot deformities
  • Incontinence

Symptoms of Spina Bifida Occulta:

  • Spina Bifida Occulta is asymptomatic, i.e., having no symptoms.
  • Mild defect may have no symptoms with only a birth mark, dimple or a hairy patch on back. These mild defects are found in Spina Bifida Occulta.
  • Back pain and stiffness
  • There may fat pat on the Occulta at the spine base.

Spina Bifida and Back Pain:

According to a scientific research, Spina Bifida does not influence the onset of scoliosis and back pain. A study has shown that patients who do not experience back pain, 20% had uncomplicated Spina Bifida Occulta.

Treatment of Spina Bifida Occulta:

  • MRI is the most helpful, which can measure the nerve roots and any soft tissue formation in the spinal canal.
  • As this problem occur early in pregnancy period, it cannot be operated.
  • It can lead to permanent disabilities requiring long term management.
  • Hence, children require a frequent examination.
  • If problems are detected in limbs or bladder and bowel dysfunction, then surgery can cure the defects.
  • It can also be prevented before birth. For this, a mother has to take required folic acid doses before and after becoming pregnant.

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