Preventative care, surgical intervention, and symptom management is the three-pronged treatment approach for spina bifida. The goal of preventative treatment is to reduce the incidence of spina bifida. When spina bifida does occur, the hope is that surgical intervention will negate the need for ongoing care and symptom management. Symptom management is directed at correcting functional problems. Here is a breakdown of common spina bifida treatments.
Preventative Care
The most effective way to treat spina bifida is to prevent it in the first place. A key component in preventing spina bifida is for the mother to have a diet high in folate. Foods rich in folate include dark green vegetables like broccoli or spinach, citrus fruits and juices, beans, egg yolks, and foods enriched with folic acid. From one month prior to conception through the first trimester of pregnancy, women should eat diets high in folate. Additionally, they should take folic acid tablets. The recommended daily dose of folic acid for women of childbearing age is 400 mcg. Women at higher risk for having a baby with spina bifida can be prescribed up to 5,000 mcg per day of folic acid.
Surgical Intervention
Surgical intervention can begin in utero. Before the 26th week of pregnancy, prenatal surgery can be performed to repair the fetal spinal defect. Fetal surgery for repair of spina bifida is not without risks to both mother and baby. However, numerous studies have demonstrated that babies with severe spina bifida who have surgery inside the womb have better outcomes than those who had surgery post birth.
Prenatal surgery is a relatively new innovation, and the majority of babies still have their surgery performed after birth. Birth itself is recommended via a Cesarean section, which is widely considered the safest delivery option for spina bifida babies. Within 48 hours of birth, the newborn should undergo a spinal deformity reconstruction with closure of the defect over the spinal cord.
Symptom Management
Surgical intervention may completely resolve spina bifida. Unfortunately, in certain instances, there may be irreparable damage to the spinal cord and nerves that cannot be fixed by surgery. In such cases, ongoing care and symptom management becomes a necessary part of the treatment plan.
Ongoing care may involve more surgeries for various complicating symptoms. Scarring due to initial surgery can cause a tethered spinal cord, which needs to be corrected with further surgery. Orthopedic surgeries prove necessary when orthopedic complications like hip dislocation or scoliosis occur. Urologic surgeries can help improve continence.
Physical and occupational therapies are also important in symptom management. Such rehabilitative therapies aim to help those with spina bifida progress along the normal developmental sequence. Gross motor achievements and fine motor skills needed in activities of daily living take particular precedence. Special education and academic support may also be a necessary part of supportive care.
