Spina bifida (myelomeningocele, meningocele, occulta) – causes, symptoms, treatment


The term “spina bifida” comes from the
latin “split spine,” which is actually a pretty good description, because spina bifida
is a birth defect where the tissue on the left and right side of the back that normally
come over the spinal cord to protect it, don’t completely meet up to form a nice seal, leaving
behind various degrees of an opening right down the middle of the lower back. Very early on in fetal development, the ectoderm,
which is the outer layer of the fertilized egg, starts to develop a bit of a ridge that
eventually becomes the neural tube. This neural tube goes on to become the spinal
cord, the brain, as well as tissues that enclose and protect them, called the meninges, and
spina bifida occurs when a portion of this neural tube fails to close properly, typically
in the lower back. This constitutes a defect or absence of the
vertebral arches due to failure of mesoderm to organize over the region of the defect,
and it may or may not involve the underlying meninges and neural tissue. Alright so there are three main types of spina
bifida, the first is myelomeningocele, also called meningomyelocele, and this is the most
severe of the three and occurs when the spinal cord and the surrounding meninges protrude
out of an opening in the bony vertebrae and are held together by a sack of skin that pouches
out from the back. In really severe cases, there is no skin at
all, and the nerves of the spinal cord are therefore exposed, a condition called ‘open
spina bifida, and this can cause serious damage to the exposed nerves as well as risk an infection,
resulting in symptoms like loss of sensation or paralysis in the areas of the body below
the damaged site, bladder or bowel movement problems, seizures, as well as leg and foot
deformities. Now a myelomeningocele is typically associated
with a condition called an Arnold Chiari II malformation, which is where cerebellar and
brainstem tissue slip down into the foramen magnum—the opening at the base of the skull. This Arnold Chiari II malformation results
in a variety of symptoms related to the cerebellum and often resulting in hydrocephalus—an
abnormal accumulation of cerebrospinal fluid in the brain. Alright the second type of spina bifida is
meningocele, sometimes called a meningeal cyst. In this condition, the prenatal spinal deformities
result in only the meninges (and not the spinal nerves) slipping into the gaps between the
deformed vertebrae. This one’s the least common form of spina
bifida, and because the spinal cord itself is not damaged, these individuals often do
not experience the severe symptoms that are seen in myelomeningocele. Alright the third type and finaly type is
spina bifida occulta, and this is the most common and most mild form of spina bifida. In fact, ‘occulta’ is latin for hidden,
which is appropriate since many of the normal prenatal tests used to diagnose spina bifida
don’t catch the disorder because the deformities in the tissues of the lower back are tiny. In spina bifida occulta, the spinal cord and
surrounding tissue don’t protrude, nor is any of the tissue forced into the spaces in
between the vertebrae. Since the spinal nerves are undamaged, people
with this form of the disorder are often asymptomatic, and the condition is usually only found accidently
later in life. At most, people might have hair, a dimple,
or birthmark on their back above the site of the lesion. Now, the exact cause of all three types of
spina bifida isn’t known, but there are known risk factors like folate or Vitamin
B9 deficiency during fetal development. Therefore prenatal vitamins include folic
acid, which is the manufactured form of folate. The developmental deformities, though, that
cause spina bifida often take place in the fourth week of pregnancy (which is 21-28 days)
and this could be before a woman might know she’s even pregnant, and therefore she’s
not taking prenatal vitamins yet. To help combat this, enriched grain products
like breakfast cereals made with whole grains have folic acid added to flour as a general
preventative measure. Other risk factors for having a child with
spina bifida include obesity, poorly controlled diabetes, and taking medications that interfere
with folate metabolism like certain anti-seizure medications. Diagnosis for the most severe form of spina
bifida—myelomeningocele—is often done prenatally by looking for an increased level
of alpha fetoprotein (or AFP) in the mother’s serum, which can happen when the skin surrounding
the fetus’s spine is missing and AFP leaks into the amniotic fluid and into the mother’s
bloodstream. AFP, though, can be elevated by other conditions
as well so in order to get a more exact diagnosis, additional blood tests for Human chorionic
gonadotropin (or HCG), inhibin A, and estriol, as well as an ultrasound are usually done. In more serious cases, amniocentesis (where
a sample is taken directly from the amniotic sac surrounding the fetus) can be performed. For treatment, prenatal surgery is done to
close a myelomeningocele, but this surgery can be dangerous to the developing fetus as
well as the mother. In cases where postnatal surgery is chosen,
it is often done within the first few days of an infant’s life in order to minimize the
risk of infection like meningitis. Even if the surgery is successful, people
with this condition typically need additional interventions such as urinary catheterization
to help with urination and crutches or wheelchairs in case of paralysis or low muscle tone, because
the damaged or underdeveloped spinal nerves can’t be repaired. Alright, as a quick recap, the three types
of spina bifida are spina bifida occulta, which is the most common and least severe,
meningocele, which is the least common and also typically not very severe, and myelomeningocele,
which is the most severe form of spina bifida. Thanks for watching, you can help support
us by donating on patreon, or subscribing to our channel, or telling your friends about
us on social media.

83 Replies to “Spina bifida (myelomeningocele, meningocele, occulta) – causes, symptoms, treatment”

  1. Great video. I wonder if the affected section of spinal cord (depicted at 0:46–> as the donut-resembling ring with a triangular piece missing) will remain that way or rather develop to a normal one with a delay (so that only the vertebral arch would defect persist). Because wouldn't some important, dorsal neural cell nuclei and tracts otherwise be missing from that level completely? Or is the neural tube enclosure defect tiny enough to not cause any noticeable changes e.g. in the function of sensory and motor tracts of the spinal cord?

  2. Osmosis is making my nursing school experience much easier. I read the topic at head and then watch your videos to get a clear understanding you guys are a life saver thank you for your work!!!!

  3. wow….. just with this one single video, i could clearly explain to others with confidence what i've just learned. these osmosis videos are amazing!!! thank you

  4. great video..I feel like I got lucky..I have last defect occulta. I've never had a problem except for when I began to gain weight.

  5. please check out our new chanel. we have a daughter who was born with spina bifida. please subscribe to follow our journey.

  6. Relation to cerebrospinal fluid leaks and ehlers danlos? Please do videos on cerebrospinal fluid leaks and chiari malformations. Great job!

  7. i have seen many medical tutorial video but i have never seen comprehensive and simple but yet detailed explanation like yours. please do more video .. YOU ARE THE BEST!!!!!!!!!!

  8. thank you for all your videos. I'm gonna score good marks in my university exams . all because of you thank u so much 😄😄😄☺😊

  9. In my nursing book it says meningomyelocele and meningocele ,both comes under spina bifida cystica and in other book both the cases is presented different ,can you please explain it for me ?

  10. Spina Bifida cystica occurs when there is an actual protrusion of the spinal cord and meninges through a defect in the vertbral arch. Spina bifida cystica can take two forms. Meningocele and myelomeningocele. Spina bifida occulta is the mildest form of spina bifida and occurs when there is a gap in one or more of the vertebral arches, but the spinal cord and meninges remain within the vertebral canal. Approx. 10 percent of the general population has this variation in development. bladder and/or motor problems

  11. it is a great video to explain because i have my sister having spina bifeda and because the spina bifeda she have a kidneys problem and heart problem the spina bifeda it is so hard to have it becuase is so sad at the same time

  12. I have myelomeningocele with hydrocephalus and I had meningitis that was treated quickly. I have struggled academically through middle school, high school, and I failed college both years I went. I DON’T HAVE ANY FRIENDS. I WORK FOR MY DAD’S BUSINESS BUT I CAN’T CONCENTRATE AT WORK. ALL I FUCKING WANT TO KNOW IS IF MYELOMENINGOCELE CAUSED THIS AND I’M NOT GETTING A FUCKING ANSWER FROM ANYONE!!!

  13. Austin, a pediatric surgeon helps counsel expecting parents faced with the option of having surgery on their babies in utero. Source: http://www.birthdefects.org/surgeons-birth-defects-hid/

  14. I'm 19,I have just found that I have Spina Bifida noted at LV5 after I did a X-Ray Scan on the lower back because I have mild lower back pain,What Should I do, please?
    Sorry for my bad grammar.
    Regards from Egypt.

  15. yey! thank you osmosis! this was our topic last friday and I need to review again about it though I have a notes,I still need to watch this for additional.

  16. Hello, just wanted to ask, do you guys agree with Folic Acid fortification (adding synthetic Folic Acid to food), foods like rice or bread ?? Or do you prefer the natural Folate??????? I heard it decreases risk of Neural Tube Defects like Spina Bifida. Studies from 2015 says that Folic Acid fortification is 95% successful in terms of decreasing risk of Spina Bifida within 3 years but a synthetic is different from an organic.. so…… Just wanted to ask do ya'll agree with Folic Acid fortification?

  17. You might want to update your video. It does not include the most severe form of SB . That Rachsisis the whole Spine is exposed with a 99 percent fatality rate. I have have myleomeningocele

  18. i am diagnosis with the first type i.e. MENINGOMYLOCELE since birth having having urine and stool incontinence.. Thanks for the video.. nicely explained.. 🙂

  19. very clear and relevant information, not too quickly explained and great illustrations. Your video's teach me in minutes what teachers try to explain in 2 hours. thank you very much.

  20. spinal dysraphism is noted at L5-S1 level through posterior elements from which herniation of CSF containing cavity with herniation of meninges and low lying tethered cord from bony defect -spina bifida with meningomyelocele
    Sir ye report h meri beti ki jo 6 month old h ab m kya kru opration krwau ya wait kru

  21. I’m 15 years old and i just found out that I have spina bifida myelomeningocele (the most severe part) I have a scar on my back and I was always told that they removed something and I’ve never given it much thought, I also have absolutely no sensation on my right foot, but I can still move it, I was told that it was this way because they touched a nerve in surgery and I lost sensation, my parents told me these lies because they didn’t want me to feel like i had limits or like i was disabled in some way, I have always performed badly in P.E, and people always tell me that i run funny, I just found out because i was having back pains and I started to limp a little, but im truly grateful for my parents because really if I had known I would have used this as an excuse to not do P.E, to stop running because I ran weird, anyway this video really helped me understand this condition but now im afraid, the doctor told me about how surprised he was that I can run, walk and do stuff, since I had the most severe type of spina bifida, and that Im really lucky and stuff but now there is so much that i dont know like will i lose the ability to walk as i get older??? Will my kidneys fail??? I’m so afraid now and i wish this limp never have appeared so I wouldn’t have known that i had this

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