Spina bifida is a type of congenital neural tube abnormality. The neural tube forms in the early days of human gestation, closes up by week four, and eventually becomes the spinal cord, brain, and meninges (the tissue that surrounds these structures). Spina bifida, literally “split” or “cleft” spine, is a disorder in which the neural tube never fully closes. Exactly what causes spina bifida is still unknown, though genetic and environmental factors likely play a large role. Here is a look at what spina bifida is and how this disease affects adults.
Types of Spina Bifida
There are four types of spina bifida: occulta, closed neural tube defects, meningocele, and myelomeningocele. Spina bifida occulta (meaning hidden and referring to the skin that covers the abnormality) is the least severe and most common form. The abnormality is limited to extra tissue or even a hole in the vertebrae. Because the nerves are usually unhindered, there are generally few to no symptoms associated with occulta.
Closed neural tube defects may be grouped with occulta and involve an abnormality of fat, bone, or tissue; these abnormalities are often marked externally by hair, a mole, or a fatty deposit. Again, symptoms are minimal, although there may be inhibited excremental control or pain in the lower body.
Meningocele and myelomeningocele are open neural tube defects and generally more problematic. In meningocele, the meninges and spinal fluid bulge out of the spinal cord forming a sac that, while visible on the back, “contains no neural elements and may or may not be covered by a layer of skin,” according to the National Institute of Health. Symptoms can vary widely, from absence to paralysis.
Myelomeningocele is the most serious type of spina bifida; several vertebrae fail to close, and the spinal cord, meninges, and cerebral fluid bulge out into a sac that is usually uncovered. This results in exposure of the neural elements to infection (such as meningitis) and causes serious impairments. A lack of bladder and bowel control, pain and weakness, seizures, orthopaedic abnormalities, and paralysis can be present in varying degrees.
Spina Bifida in Adulthood
Improved health care and treatments means longer life spans for those who suffer from spina bifida, but it also raises new concerns: the navigation of adulthood. By starting in early childhood, adolescents can begin learning to cope with the world around them despite extensive needs. Even severe spina bifida doesn’t have to be a detriment to a full life. Beginning to learn how to care for their own needs, from managing health care to arranging transportation, can help produce functioning adults.
Because people with spina bifida already face advanced health needs, it’s important to engage in as many healthy behaviors as possible. The CDC recommends an hour of exercise a day, even for those dealing with partial paralysis—taking a walk with assistance or wheeling yourself around the neighborhood can provide sufficient activity.
Mental health is equally important; socializing and engaging in support groups can help reduce feelings of isolation caused by being struck by disability. Family planning and sexual health play just as vital a role in those with spina bifida as those without; this disability rarely affects fertility. However, it is important to understand the genetic influence of spina bifida before reproducing.
