Advancing our Understanding of Treatments for Spina Bifida Patients

Spina Bifida is a neurological disorder in which the spinal column of a developing fetus does not close correctly. This neural tube defect occurs within the first month of pregnancy and can cause damage to the nerves and spinal cord. The effects of Spina Bifida range in severity, with the most severe cases having a myelomeningocele (MMC), which is an incomplete spinal canal. Hydrocephalus (excess cerebrospinal fluid in the brain) is, according to this review, the most important comorbidity of MMC, because a buildup of fluid in the ventricles of the brain causes pressure to be put on brain tissue which can lead to a variety of negative effects. Treatment for hydrocephalus is usually the placement of a shunt to drain excess CSF down the spinal column. 

In this review, researchers discuss key aspects of hydrocephalus, assessing where current research stands. One thing they discussed was intrauterine closure of myelomeningocele (IUMC), which has been proven to reduce cases of hydrocephalus in Spina Bifida patients. In cases where IUMC is not an option, patients must undergo surgery to close the MMC and to place a shunt for hydrocephalus. Doing both in one surgery can reduce the strain on the child. In less severe cases, there has been a recent trend towards treatments that care for infants with MMC while delaying the placement of a shunt, and this has led to a reduction in the number of cases which need a shunt to combat hydrocephalus. Throughout infancy, childhood, adolescence, and adulthood, shunt failure is relatively common. Recent research has increased understanding of the signs of shunt failure, and more must be done to minimize its frequency in the future. 

Spina Bifida is very interesting to me, because it is a disease which affects the nervous system, and therefore has impacts on multiple bodily processes. I think it is amazing and a testament to the complexity of the human body that people with Spina Bifida can live with damage to a structure as vital as the spinal cord. Continued research has led to amazing advancements and expansion of our knowledge on Spina Bifida and hydrocephalus. The researchers in the review mentioned that more research needs to be done on adults with this disorder because people are living longer with the condition, and I think that is an incredible reminder of how far we have come, and how far there still is to go. 

Source: 

Blount, J. P., Maleknia, P., Hopson, B. D., Rocque, B. G., & Oakes, W. J. (2021). Hydrocephalus in Spina Bifida. Neurology India, 69 (Supplement), S367–S371. https://doi.org/10.4103/0028-3886.332247