Spina bifida is a congenital anomaly of the spine and spinal cord, occurs due to the vertebrae not fused together, a gap is formed between them and part of the spinal cord with nerve roots protrudes between the vertebrae. In most cases, pathology occurs in the lumbosacral region, less often in the cervical, thoracic region spine. This is a very serious disease and the clinical picture depends on the degree of exposure of the nerve tissues to the vertebrae. Today, spina bifida is diagnosed in 50% of all lesions of the musculoskeletal system.
An abnormal defect can be detected in the womb, this makes it possible to accept preventive measures, even before the birth of the child. After all, having discovered a fetal pathology, doctors always advise terminating the pregnancy. But not every mother will decide to take such radical measures, so if a woman decides to give birth to a baby, then immediately after birth it is necessary to begin treatment for spina bifida, this will help prevent severe disability in the future.
Scientists have not identified a clinic to date. But it is known that a certain role in proper development the fetus is played by a lack of vitamins and microelements, especially folic acid is required in large quantities for proper formation nervous system baby.
Uncontrolled use has a negative effect on the formation of a hernia in the fetus. medicinal substances, use of alcohol-containing drugs. Cerebrospinal fluid is formed in the first weeks of pregnancy, it is during this period of time that specific factors can affect the appearance of a spinal hernia in the unborn baby.
Spina bifida in newborns is not a genetic pathology, so you should not be afraid to get pregnant; if you follow the doctor’s recommendations and maintain a healthy lifestyle, you will have a full-fledged baby.
Types and classification
The location of the spina bifida is an important factor for the patient and the doctor. After all, a person’s life and the complexity of treatment directly depend on this. Spina bifida is divided into the following types:
Hidden, revealed mild form course of the disease. Characterized by damage to the structure of one vertebra . A person with this type of hernia does not feel any particular pain symptoms. The only thing is that on palpation, at the site of the unhealthy vertebra, a small depression is felt. Visually, hyperemia with hairs is noticeable at the site of the disengaged vertebra.
Hernia, this type of pathology entails severe consequences and symptoms. In addition to the fact that the protrusion is visible to the naked eye, it is classified as a neoplasm that is filled with cerebrospinal fluid, with nerve processes and ligaments. In most cases, the nerve processes can fulfill their purpose normally, but if they are affected, the baby is born with a complex of neuropsychic disorders and a number of somatic diseases.
In rare cases, each type may be accompanied by a complication in the form of a tumor. Basically, benign lipoma tumors are added to the hernia. They are located on the membrane of the spinal cord or on the processes of the intervertebral discs. The tumor does not have time to transform into a malignant form, since it is removed together with the hernia during surgery.
Disease classification:
- Meningocele (meninges). With this pathology, there are no symptoms from the nervous system, since the brain is formed as expected, the only thing visible is a small tubercle on the spinal column, covered with thinned tissue. skin. Symptoms are characterized by the size of the protruding spinal cord along with the nerve roots and membranes of the vertebral arches. The location and content of the neoplasm. The most encouraging prognosis is for a small tumor with protrusion of only the Meningocele;
- Mielomeningocele - in in this case protrusion of the meninges involves tissue of the spinal cord (Myelomeningocele). The nerve roots partially enter the hernial tumor. As a result, the medulla has irregular, curved shapes;
- Mielocystocele is a very severe form of the disease that involves a disruption of the structure of the cerebrospinal fluid. Mielocystocele in infants is manifested by paresis of the legs, dysfunction of the large and small pelvic organs. A hernia is characterized by an accumulation of brain fluid entering through the large opening of the vertebral arches;
- Rachischisis is the most severe and incurable pathology. It is characterized by complete damage to the membrane of the spinal cord, vertebrae and soft tissues of the body. In this case, the brain is completely on the surface and is not protected by the skin. According to statistics, it ends in death in 100% of children.
Hernia of the spinal cord with various defects of the nervous system and paresis lower limbs. In most cases, it occurs with complications, such as involuntary urination and bowel movements.
Symptoms
A latent type of pathology, rarely manifested by any symptoms or disorders in the human body. Compared to open cleavage:
- Paralysis of the lower extremities, complete or partial;
- Hydrocephalus (fluid accumulation in the brain);
- Disruption gastrointestinal tract, liver, kidneys;
- Nervous system disorders: epilepsy, nervousness, loss of body sensitivity;
- Asymmetry and unnatural position of the legs.
Diagnostics
The disease can be diagnosed when the baby is still in the womb. And:
- The pathology of the development of cleft vertebral discs will be shown by ultrasound during a perinatal examination. Indication clinical trial blood and amniotic fluid of a pregnant woman for the presence of alpha-fetoprotein, also indicating abnormal fetal development;
- After the birth of the baby, the spinal protrusion is visible to the naked eye. It looks like a bag covered with transparent skin with liquid secretion inside. In rare cases, the spinal part comes out;
- To accurately diagnose and clarify the type of hernia, an X-ray examination is required; MRI or CT diagnostics are used to identify concomitant disorders in the body;
- A neurological examination includes an assessment of muscle tone, with what force the baby rests his lower limbs on the surface, and an analysis of the contents of the hernial sac is taken.
Myelography is an additional diagnostic technique, performed using a contrast agent, which allows for an accurate assessment of brain damage in a child.
Treatment
There is an effective way to treat spinal hernia , but unfortunately it is carried out only abroad. The operation is performed when the fetus is in the womb at approximately 20 to 25 weeks of pregnancy. The essence of the surgical intervention is to close the pathology in the spine. As a result, the spinal tube returns to its place, and the vertebral fissure closes. Statistics show that the consequences of perinatal intervention in a child after birth are rarely noticeable. And timely care and compliance with all the doctor’s instructions will ensure the life of a full-fledged and healthy person.
In Russia they are trying to carry out such complex operations, but today you can count on your fingers the number of specialists capable of performing this procedure. Therefore, our centers mainly perform postpartum surgery.
Congenital spina bifida, is very difficult to treat. It is possible to completely cure and put a child back on his feet in rare cases. The patient should always be observed by a doctor, since the risk of complications of the disease will not disappear on its own. If a spina bifida is detected in a newborn, emergency or planned surgery is required, depending on the classification of the disease.
In most cases, surgery is performed in the first three days of the baby's life. Some scientific luminaries are of the opinion that surgical intervention is not necessary. The main thing is to accept the important and the right decision. It is required to conduct a thorough study and diagnosis of the lesion, taking into account all existing risks and complications after surgical intervention.
It will not be possible to completely cure a child, but it will be 100% possible to alleviate his condition and create full-fledged quality of life conditions with the help of surgical treatment.
Spinal diseases such as osteochondrosis and spinal hernia in children and adolescents worsen their quality of life, reduce their overall performance and quality of education. If the disease is neglected, it can even lead to permanent disability. In childhood, the process of education intervertebral hernia often occurs acutely after injuries or overload of the spine. The fibrous rings of the intervertebral discs rupture and the contents of the disc migrate into the spinal canal. Then, at any time the child overloads the spine, the process of herniation may begin.
Causes
Incorrect posture and shoes that do not fit properly lead to spinal curvature in children, the development of osteochondrosis, and scoliosis. In such cases, a spinal hernia can form even after minor loads on the spine.
The risk that many children and adolescents expose themselves to when playing sports often leads to spinal injuries. This will certainly affect his condition in the future. At first, the child experiences stiffness in the back, a nagging feeling of heaviness, and frequent causeless irritability. Most often, the lumbar spine is affected in children.
It should be noted that the causes of spinal hernia in children and adolescents are different. The spine is affected by unfavorable mechanisms and biological factors throughout life. Due to upright walking, considerable daily loads are placed on the spine. In children, they are further aggravated by stress at school, improper posture, congenital structural features of the neuromuscular structure of the back, individual characteristics of the blood supply to the disc, regeneration and quality of nervous tissue. The cause of spinal injuries in children can be a direct impact on it in the form of a bruise, a fall, jumping over the head, lifting heavy objects, severe twisting or bending of the torso, as well as birth trauma.
This is dangerous for children!
Excessive stress on the spine is harmful to children, but physical inactivity is much more dangerous for them. The gradual loss of muscle tone leads to damage to the muscles and ligaments of the spine, manifested in instability and pathological mobility of the vertebrae. This, in turn, leads to inevitable damage to the intervertebral discs in children.
Long-term monotonous loads pose a particular danger to children and adolescents. Systematic excessive loads, including long periods of sitting at the computer, harm the spine. This leads to early adolescent scoliosis and instability of the cervical spine. Frequent complaints in children in such cases may be dizziness and headaches. Also, obesity certainly weakens the child, often leading to the development of spinal pathologies. Excess weight- this is always an excessive load, to which the lumbar spine is especially susceptible.
Treatment
The best treatment for spinal hernia in children is physiotherapy(physical therapy). It is prescribed both during the period of exacerbation and for prevention intervertebral hernia for scoliosis and osteochondrosis. However, if a hernia already exists, any exercise should be preceded by high-quality conservative treatment. In children, it usually includes massage, manual therapy of the spine, and underwater traction with simultaneous treatment with anti-inflammatory nonsteroidal drugs to relieve pain and swelling. And at the end of the treatment, the doctor selects a set of exercise therapy exercises. It is justified to prescribe procedures from a qualified exercise therapy instructor. Children's intervertebral hernia is not the case when group classes are indicated. Individual training with a small patient is prescribed.
A child’s health largely depends on his habits and adaptive reactions. Bad habit slouches, poor posture leads to muscle stiffness. Long lessons and improper sitting at the table lead to scoliotic deformity of the spine. In children, foci of premature development of osteochondrosis occur, scoliosis develops, and subsequently complicated forms of spinal diseases arise (spinal hernia, vertebral displacement). Parents, be careful! If your child clearly has poor posture, is bothered by back pain, is often tired and feels heaviness in the spine - contact a specialist immediately.
Spina bifida in children is a congenital anomaly due to which one or more vertebrae during their development do not close in the area of the spinous processes, resulting in the formation of a gap into which the spinal cord itself and its membranes fall out. This problem is most common in the lower spine, although in some cases it can occur in other areas. In this case, the severity of the disease is determined by the size of the area of nerve tissue that is left without appropriate protection.
Such a hernia in the fetus is determined by the results of an ultrasound scan, so intrauterine diagnosis is quite possible of this disease.
Why does spina bifida occur in infants?
So far, no one can name the exact cause of the development of this disease, but it is generally accepted that the most important factor in this case is vitamin deficiency.
In addition, this disease is congenital, but not genetic. There is an opinion that if a woman gives birth to a child with such a defect, then there is a possibility that such an anomaly will appear in other pregnancies. But in practice, in cases where a woman began to take care of obtaining all the necessary vitamins and minerals for the development of the child, the occurrence of such a defect is practically excluded. Thus, a congenital hernia may well be a “one-time” problem, and it will not occur during the next pregnancy.
What types of spina bifida are there?
There are two main types - hernial and hidden cleft.
Hidden clefting is the most common situation and is considered a mild form of the disease. In this case, the shape of only one of the vertebrae is usually slightly disturbed. Most people with this type of disease do not have any problems and do not notice any symptoms of the disease, except for a small depression located above the affected area of the spine.
Hernial cleft is considered a severe form of the disease, since with it the vertebral defects are much more serious. The most noticeable sign of the presence of this disease is a hernial protrusion, which contains the membranes and the spinal cord itself, as well as cerebrospinal fluid. But quite often the nerve roots remain intact and function normally. The situation is much more complicated when the hernial protrusion contains not only the spinal cord and its membranes, but also nerve roots and trunks. In this case, the child is often born with a number of severe sensory and motor disorders.
What are the symptoms of such a disease?
As we have already said, with a latent type of disease there are practically no symptoms. Hernial cleft manifests itself quite seriously; with it, the following can be observed:
- leg defects and incorrect leg position;
- complete or partial paralysis of the legs with loss of sensation;
- Almost always, hernia and hydrocephalus appear simultaneously. Moreover, if such a disease is not treated, then neglected form it leads to serious disturbances in brain function;
- there are almost always problems with bladder up to its paralysis, which leads to urinary incontinence, rapid spread of infections and destruction of the kidneys themselves. Often the anus and rectum are also paralyzed.
Is this disease treatable?
Unfortunately, this disease is practically untreatable. This is precisely the case when you need to take care in advance that it does not appear, since it can be cured in to the fullest almost impossible.
In general, a patient with such a disease is constantly under the supervision of the attending physician, which is especially important for children in whom spina bifida is accompanied by hydrocephalus. To get rid of bladder problems, hygienic maintenance methods and a number of urological procedures are used. To eliminate chronic constipation caused by problems in the rectum, a special diet is prescribed that includes a large amount of coarse plant fiber.
Some physiotherapeutic procedures partially help restore mobility, thanks to which a sick child can become completely independent. Otherwise you will need a wheelchair.
It is better not to joke with such a diagnosis as herniated intervertebral discs, since the spinal cord passes through the spinal canal, from which nerves depart that provide innervation to organs and systems. Naturally, when nerve endings are compressed, not only symptoms of pain may appear, but also disturbances in the functioning of certain organs. According to statistics, it is the lumbar region that is often affected, since it accounts for not only motor activity, but also the need to withstand body weight. The lower back is often susceptible to injury during sudden movements, due to muscle overstrain when lifting heavy objects, and, as is known, it is not so easy to relieve pain when the lumbar area hurts. Let's look at the causes and signs of a lumbar spinal hernia, as well as the principles of treatment, including pain relief, physical therapy, tips on how to sleep and how to sit correctly. Let's look at what a hernia is in terms of anatomy and physiology.
The lumbar spine consists of 5 large vertebrae connected to each other by intervertebral discs, which, in turn, create a shock-absorbing function. Discs are also necessary to evenly distribute the load across the lumbar region. The reliability of the disc is ensured by the fibrous ring, and inside this ring there is a core of semi-liquid consistency. With increasing loads, after a back injury or other circumstances, destruction of the fibrous ring is possible, that is, the appearance of cracks through which the core partially enters the spinal canal - protrudes. Thus, over time, a herniated intervertebral disc forms, which, in turn, can compress nerve endings, blood vessels, and narrow the lumen of the spinal canal, which leads to negative consequences. The patient may be at risk of disability due to a hernia, disrupting the functions of the genitourinary system, gastrointestinal tract, causing paralysis of the lower extremities, so we will consider the causes and risk factors to protect ourselves from this pathology.
Causes
Intervertebral hernia is one of the rare pathologies, which can result from both an overly active lifestyle and a sedentary lifestyle. Most often, a person is faced with the fact that he has signs of a hernia of the cervical spine and lumbar region. A herniated disc in the lumbar region can be caused by permanent loads on the muscular system, that is, people whose work involves lifting weights and working with vibrations suffer. The second risk group is athletes, and weightlifters are especially susceptible. If at a young age intense training keeps the muscular system in good shape, then with the cessation of training, old injuries and damage to the musculoskeletal corset in the lumbar region begin to appear.
In women, childbirth is often the cause of a hernia, and it may not be the birth itself that is to blame, but weight gain during pregnancy, and after it, carrying the child in your arms. There are problematic births, when the fetus is large or has an incorrect presentation, then the risk of spinal injury increases.
Risk factors for developing a hernia in the spine:
- getting a back injury, especially in an accident when the body experiences a shock or jerk;
- a blow to the back with a blunt object or a fall from a height onto the back;
- impaired metabolism due to alcohol abuse, junk food, due to diabetes, smoking;
- lack of vitamins and minerals, a particularly pronounced condition with the aging of the body;
- obesity, which increases the load on the lower back.
Most often, these reasons are combined, for example, people with diabetes are prone to obesity and a sedentary lifestyle. It is worth noting that a lumbar hernia is not immediately noticeable, since the disease is characterized by progression, a slow onset of the development of the pathological process. A degenerative-dystrophic process is observed in the spine, accompanied by impaired nutrition of the discs, which is why it loses its strength. That is why the disease can also be caused by various infections, such as tuberculosis and syphilis, which affect the body systemically.
And of course, do not forget about the factor predisposing to hernia – osteochondrosis. Most patients with a hernia have a history of this disease, since osteochondrosis affects the structure and nutrition of the spine.
Symptoms
Most often, a hernia in the lower back develops between the L4-L5 vertebrae, a little less often the sacral region is also involved in the process, that is, in L5-S1, which is why we can conclude that the lower lumbar region suffers and this is associated with increased loads on this area.
Consequently, the symptoms often involve in the process not only the lumbar area, but also the buttocks and lower limbs, which is why the disease is characterized by such complications as lumbago, strangulation in the sciatic nerve, radiculopathy and others. Therefore, it is better for patients with a hernia not to joke with their health, so as not to trigger the disease, since complications of a hernia lead to the fact that the patient is often unable not only to run or swim, but also to walk normally.
The pathology is characterized by symptoms of pain, the strength of which increases with exercise. If there is compression of the nerve endings, then lumbago appears - sharp pain with every movement, which passes in a state of rest. Pain relief for lumbago with conventional drugs (analgesics, NSAIDs) is not always helpful, so, as a rule, patients seek medical help. In addition to pain, a person with this diagnosis suffers from stiffness in the lower back, sensitivity is impaired, and a burning and tingling sensation appears at the site of the hernia formation.
When inflammation develops due to compression of the spinal cord or nerve endings, additional symptoms appear. In addition to the fact that the pain sharply intensifies from turning or tilting the torso, the sensations of pain spread to the buttock area, go down the legs, right up to the toes. The patient may have problems with genitourinary system, manifested in decreased potency, retention, or, conversely, uncontrolled urination. The gastrointestinal tract may be affected. If the hernia is not treated, the patient is at risk of developing paresis and paralysis.
Conservative treatment
With the help of conservative treatment, it is unlikely that it will be possible to cure the hernia completely; in many respects, everything depends on the size of the hernia, but if you start treatment in the early stages, you can stop its growth, that is, stop its progression. Moreover, if you strengthen the muscle corset, you can avoid squeezing the nerve endings, which is why doctors often resort to non-surgical treatment.
Therapy has two directions at once, the first of which is aimed at eliminating the symptoms of pain. The following methods are used for this:
- drug therapy - drugs from the NSAID group (Ibuprofen, Diclofenac, Meloxicam), muscle relaxants (Sirdalur, Mydocalm);
- non-traditional methods - acupuncture (acupuncture), by the way, acupuncture can only be performed by a doctor;
- spinal blockade using hormones - Diprospan, Kenalog in combination with Lidocaine.
A blockade for a hernia of the lumbar spine is prescribed when other methods of pain relief are ineffective, since with the introduction of hormones there is a threat of development side effects. The hernia is blocked once every 3 months, more often in advanced cases. Acupuncture for hernias is used to reduce pain symptoms.
The second direction of treatment is aimed at strengthening the muscles, which requires training to pump up the muscles. But do not forget that the training program should be selected individually. A popular technique is hyperextension for a herniated lumbar spine, that is, special exercises aimed at strengthening the muscles of the lower back. For this purpose, special simulators are used for hernia.
A lumbar bandage, which must be worn as directed by a doctor, helps reduce the load on the spine. Some doctors recommend using an exercise bike for exercise. By the way, it is not recommended to pump the abs during a hernia in the usual position from the floor, so you should not perform exercise therapy exercises that the doctor has not prescribed.
Swimming is effective for hernia, which is why swimming is recommended for prevention, especially for people with spinal curvature. Replace sea water the pool will be able to, and if you go to the pool with osteochondrosis, then the chance of developing a hernia decreases. If a woman is expecting childbirth, then she is also recommended to visit the pool, but she needs to work out with a trainer and after consulting a gynecologist, then the birth will be successful.
By the way, about issues of prevention. You can give a technique that helps strengthen, pump up all muscle groups and protect the spine from osteochondrosis, hernia - this is a fitball. Fitball is an excellent prevention of diseases of the musculoskeletal system, which consists of exercising with a special elastic ball.
Don’t forget about nutrition if you have a herniated disc. It is necessary to exclude alcohol, cigarettes, fatty and fried foods. It is recommended to add vitamins to your diet.
Physiotherapy for lumbar hernia is often indicated to relieve inflammation. The question arises: is it possible to use all ERT techniques; the answer is no. A doctor can select procedures, since electrical stimulation has a number of contraindications. Electrophoresis helps well with hernia of the lumbar spine.
Prevention of complications
Now he will talk about what is and is not possible with the disease, that is, contraindications for a hernia of the lumbar spine. Be sure to follow a diet for a hernia; walking helps, since a sedentary lifestyle negatively affects the disease.
Massage and going to the pool are allowed, that is, swimming is not only possible, but also necessary. Among exercise therapy exercises, lifting weights is prohibited, that is, strength exercises, techniques that can severely stretch muscles and ligaments. Squats are only shown in the early stages. By the way, squats and abdominal pumping help with preventive purposes, and as you know, prevention is better than cure.
You cannot self-prescribe painkillers for a hernia, lift heavy objects, or sit on a chair for a long time. Many people are concerned about the question of how to live with such a diagnosis, but with early treatment and following the recommendations, you can even prevent disability.
Of course, in advanced cases, surgery is necessary and a long period of time will be required. rehabilitation period, which includes a swimming pool, ERT, exercise therapy.
2017-01-19
Achondroplasia (photo) is a congenital disease that is associated with disruption of the growth and development of bones. Most often, the pathology affects the skull and skeleton. Features of the disease are low human stature (maximum 130 cm).
Why does the disease appear?
What is achondroplasia? Parrot-Marie syndrome (another name for the disease) develops due to a mutation in the FGFR3 gene. Less commonly, the pathology is inherited. Sometimes the fetus dies.
The main reasons for the development of achondroplasia are disorders of bone formation, which are a consequence of degeneration of the epiphyseal cartilages.
This leads to slower growth bone tissue. The skull and long bones are usually affected. One of the reasons for the occurrence of pathology is the relatively late age of parents. If the father is over 40 years old, then the chances of developing a mutation increase.
Characteristic signs
Symptoms of the disease can be recognized immediately after the birth of the child. Such children have a rather large, disproportionate head, short legs and arms. Hydrocephalus is sometimes observed.
Parrot-Marie syndrome is noted in the form of disturbances in the structures of the facial skeleton, which arise due to improper development of bones. Patients with this condition have wide-set eyes that are located deep in their sockets. Additional folds form near the inner corners of the visual organs.
Signs of pathology can be recognized by the characteristic nose. It has a saddle-shaped, flattened shape with a wide upper part. The patient's tongue is rough and the palate is high. The arms and legs of patients with achondroplasia are uniformly shortened. Patients' feet also differ - they are wide and short.
Infants with this disease often die in their sleep. This occurs due to compression of the oblongata and spinal cord. 1–2 years of a child’s life is accompanied by the formation of cervicothoracic kyphosis, which disappears after the baby begins to actively move.
Children with achondroplasia develop slowly. They can hold their head up 3–4 months after birth; babies learn to sit when they are one year old. Such children can move only from 2 years of age. The intelligence of patients is at the same level as that of healthy people.
Adults with Parrot-Marie disease can be recognized by the growth deficiency that occurs due to shortening of the legs. Women with this pathology reach 124 cm in height, and men grow up to 131 cm. In some patients, deformations of the head and nose remain noticeable. Strabismus often occurs. Adults with achondroplasia are often overweight. They may experience the development of conductive hearing loss and otitis media.
Carrying out diagnostics
It is not difficult to determine the diagnosis of the pathology, since Parro-Marie disease is noticeable by characteristic changes in appearance. Patients must first be carefully assessed to determine the level of deviation from normal skeletal formation and development. All data is entered into a table, which is compiled specifically for such a disease, and compared with the indications.
If a newborn needs testing for achondroplasia, the baby should first be examined by a neurosurgeon. You can also see changes on an ultrasound. Doctors recommend undergoing an MRI and CT scan of the brain. To examine the condition of the nasal passages and ENT organs, the patient is examined by an otolaryngologist. Sometimes an additional consultation with a pulmonologist is required. To diagnose pathology, radiography is used:
- skulls;
- chest;
- pelvis;
- spine;
- tubular bones.
If a child has Parrot-Marie disease, he is observed by a doctor from the moment of birth until the end of his life.
Therapy methods
The genetics of the disease is such that the pathology cannot be completely eliminated. At a young age, conservative treatment is used, which helps to strengthen the muscles and stop the deformation of the limbs. It is better for patients with achondroplasia to wear only orthopedic shoes; they are prescribed a complex of exercise therapy and massage. Prevention of obesity is often recommended. To do this, patients are prescribed a special menu and exclude dishes that lead to excess weight.
Treatment of achondroplasia with surgical intervention is justified only if the patient has severe deformities of the limbs and narrowing of the spinal canal is noted. To eliminate such symptoms, a laminectomy is prescribed. Sometimes surgery is performed to increase height. The limbs are stretched in 2 stages. Initially, the thigh is lengthened on one side and the lower leg on the other, and then similar actions are carried out on the remaining parts of the body.
Other operations that are often performed include:
- Vertebral fusion. Manipulations are carried out to connect individual vertebrae. The intervention helps to cope with back kyphosis.
- Osteotomy. An incision is made in the leg bone, through which the individual parts of the vertebrae are connected. The procedure is used for severe forms of modification knee joint. Also practiced for patients who have bowed legs.
Achondroplasia is sometimes treated with the use of a special growth hormone. But the drug affects each person differently.
Life expectancy with Parro-Marie disease depends on the patient’s individual health indicators and compliance with all medical recommendations.
Spina bifida in a newborn is a congenital disease, the etiology of which is still not fully understood. There is irrefutable evidence that a lack of vitamins and minerals in the body of an unborn child can lead to the development of pathology.
The disease is often accompanied by clubfoot, hydrocephalus (dropsy), as well as related diseases associated with disorders of the urinary system and digestive tract.
Congenital spinal hernia in the fetus in most cases forms in the lumbosacral region, less often in the thoracic region.
Depending on the clinical manifestations, it is customary to distinguish between several types of pathological disorders.
Causes of pathology
The etiology of this defect has not yet been studied well enough, so scientists and doctors cannot name specific causes leading to spinal cord herniation. Many chemical, biological and physical factors during the formation of the fetus affect its body. According to experts, a predisposing factor is a deficiency of folic acid in the mother's body.
If during the examination a congenital spinal hernia is detected, medical indications, with the consent of the parents, the pregnancy is terminated. Although this disease is congenital, it is not genetic in nature.
If a woman receives the entire complex of necessary vitamins and minerals, then during a second pregnancy she has a chance to give birth to a completely normal child.
Spinal bifida received the Latin name spina bifida.
There are three degrees of this defect
- spina bifida occulta
- meningocele
- myelomeningocele
The immediate cause of spina bifida is a developmental defect in which the process of development and closure of the vertebral arches, which normally form the posterior wall of the spinal canal and cover the spinal cord, is disrupted. Through a bone defect under the influence high blood pressure cerebrospinal fluid protrudes the spinal cord along with the roots and membranes, forming a hernia.
Despite the fact that spina bifida in a newborn is a congenital pathology, it is not inherited. Therefore, in subsequent pregnancies, a woman can give birth completely healthy child.
Important! If this pathology is detected in a child at an early stage, that is, in the first trimester of pregnancy, the doctor is obliged to offer the parents an abortion for medical reasons.
The decision to have an abortion is made by the parents, but it must be clarified that a minor splitting of the spinal cord without including a hernia can be successfully eliminated by surgical intervention, which is carried out in the first days after the birth of the child.
On the other hand, if a child has a severe spinal cord injury, there is a high likelihood that the child will suffer mental and physical disabilities throughout his life.
But alone surgical methods therapeutic tactics not limited. The required effect can only be achieved complex treatment, consisting of several stages. As a rule, the process cannot be completed without the involvement of various specialists: a urologist, a neurosurgeon, an orthopedist and a neuropsychiatrist. After all, the symptoms of the disease most often confirm violations various organs and systems.
Classification
There are two main types - hernial and hidden cleft.
Depending on the location, spina bifida can be:
- cervical;
- chest;
- lumbosacral (2/3 cases).
Other abnormalities of the neural tube in a child
If the closure of the anterior part of the neural tube is disrupted at the time of its formation, the child may be born with a herniated brain, a disease that affects intelligence and motor functions. A brain hernia is a protrusion of its individual sections through a defect in the skull.
The hernia can be located in the frontal region, the back of the head, and is often combined with other anomalies in the development of the bones of the facial skeleton of the head.
The formation may be small, in the form of a swelling, pulsation is felt when pressing, the skin over the tumor is usually not changed. The herniation of the brain increases in size when crying, sneezing, coughing, or bending the head. The disease may be accompanied by disturbances in the act of swallowing and sucking, and later movement pathologies are observed.
Brain herniation can only be treated surgically; the prognosis depends on the contents of the tumor. The operation is performed in the first months of the child’s life; the absence of surgical intervention can lead to rupture of the hernia, which provokes an unfavorable outcome.
Since the normal formation of the neural tube in the fetus depends on a sufficient supply of microelements and minerals in the mother’s body, their use in the first weeks after conception is considered the main preventive measure. Particular emphasis should be placed on folic acid; pre-conception planning would be an ideal option.
Future mom can attend an appointment with a geneticist and receive detailed recommendations on the use of drugs that contribute to a favorable pregnancy. Folic acid is necessary not only for a woman planning to conceive, but also for a man - the future dad. These microelements are transmitted with a set of chromosomes and have a significant effect on the fetus.
In the first weeks after conception, it is not recommended to take any pharmaceutical drugs on your own; you should avoid excessive use of cosmetics and household chemicals. After 20 weeks of pregnancy, all the baby’s organs are almost formed and the main thing for a woman is not to harm the baby at the time of development of the basic systems.
Spina bifida in newborns
When a baby exhibits symptoms of spina bifida from birth, a series of studies are carried out to identify all associated disorders and select treatment.
Diagnostics includes the following activities:
- consultation with a neurologist- examination of the child by a doctor, assessment of the baby’s motor activity, muscle tone, determination of the location of the hernia and its severity;
- magnetic resonance imaging or CT scanto study layer-by-layer images and clarify all pathological processes in the spinal cord, MRI can be performed several times, for a newborn this is a safe study;
- examination of the baby by a neurosurgeonto assess the feasibility of conducting surgical treatment and predicting postoperative recovery;
- Contrast myelography- study of the structure of the damaged area of the spinal cord, the substance is injected intravenously and accumulates in certain areas of the pathological focus, highlighting the diseased areas;
- transillumination- light scanning to assess the contents of the hernia.
Congenital spina bifida is a rare but severe developmental anomaly. This spinal cord defect occurs in only 0.1-0.03% of newborns, and approximately two-thirds of them remain disabled for life.
Doctors share different cases spinal hernias according to their location and structural features. The location of the defect plays a big role for the patient and the doctor treating him, since the severity of the symptoms and the complexity of treating the pathology depend on it.
For an accurate diagnosis of spina bifida, a complete medical checkup which begins with taking an anamnesis. In case of contacting a doctor after childbirth, in which no pathologies were detected, special attention is paid to age indicators during the period of manifestation of symptoms of the disease (weakness in the limbs, signs of atrophy and difficulty in muscle activity).
Examination by a neurologist, during which motor activity is assessed, muscle tone of the limbs is checked, protrusion is detected and relevant medical indicators are recorded;
Transillumination is a special light scanning, thanks to which it is possible to detect and characterize the contents of a hernial protrusion;
Contrast myelography – intravenous administration contrast agent that accumulates in certain parts of the spinal cord. Gives an idea of the structure of damage caused to the spinal cord during the formation of a hernia;
Read more: Causes and symptoms of muscle atrophy, diagnosis and treatment
- Perinatal surgery
- Postpartum surgery
- Additional surgical methods
Spina bifida in newborns, which is difficult to treat, occurs in 60% of all cases of musculoskeletal disorders. It is impossible to completely cure this disease in infants, but with timely treatment measures taken, the number and intensity of complications can be reduced and the child can be helped to lead a relatively normal life.
- With a mild degree of pathology, the child grows and develops in accordance with his age.
- If the spinal cord and nerve roots are partially affected, then the baby will experience urological problems, as well as problems with bowel movements. Such children require constant care and special hygiene procedures. For severe constipation, nutrition should be based on foods high in fiber.
- Children with this pathology, complicated by hydrocephalus, should be under constant supervision. Parents of such patients are taught the specifics of caring for them.
- In case of impaired mobility of the limbs, patients are prescribed courses of physiotherapy.
- At severe complications and paralysis, children cannot walk; they need a wheelchair and constant care at home.
Intervertebral hernia in adults
Symptoms of the disease
As we have already said, with a latent type of disease there are practically no symptoms. Hernial cleft manifests itself quite seriously; with it, the following can be observed:
- leg defects and incorrect leg position;
- complete or partial paralysis of the legs with loss of sensation;
- Almost always, hernia and hydrocephalus appear simultaneously. Moreover, if such a disease is not treated, then in its advanced form it leads to serious disturbances in the functioning of the brain;
- almost always there are problems with the bladder, up to its paralysis, which leads to urinary incontinence, the rapid spread of infections and the destruction of the kidneys themselves. Often the anus and rectum are also paralyzed.
A hernia of the spinal canal with protrusion of the spinal cord has a very characteristic clinical picture, noticeable immediately after the birth of the child. A tumor-like formation of various sizes located in the midline of the back, most often in the lumbar region, is visually determined.
The hernial sac is covered with thin, bluish-colored skin with cicatricial changes, and at the base there is often excessive hair growth or spots of vascular origin. The tumor has a soft elastic consistency; a defect in the vertebral arches is palpable at its hilum.
Other signs of local soft tissue dysmorphism are often encountered: lipomas, hemangiomas, fibromas.
- paralysis of the limbs, nutritional disorders, paresis;
- malfunction of the pelvic organs, bowel incontinence;
- disruptions in the functioning of the heart, lungs, gastrointestinal tract and endocrine system.
As noted above, the hidden type of defect is rarely accompanied by any symptoms or health problems.
The open type of cleft has the following symptoms:
- Unnatural position of the legs, asymmetry of the lower extremities, and other defects.
- Complete or partial loss of sensation in the body and limbs below the affected area, complete or partial paralysis of the lower limbs.
- In the vast majority of cases, hydrocephalus is observed, which results in other pathologies - epilepsy, paralysis and impaired sensitivity of certain parts of the body, various problems with vision up to its complete loss, disorders of the brain and psyche.
- The inability to control the functions of urination and defecation, as a result of which the patient may experience enuresis and encopresis, complete incontinence of urine and feces, or acute urinary retention and chronic constipation. In turn, these disorders eventually lead to infection and inflammation of the kidneys.
- A hernial protrusion on the back of a newborn is visually noticeable immediately after birth. It is a bag covered with thin leather containing soft or liquid contents. In some cases, the cerebral part of the hernia is open to the outside.
Diagnostics
IN modern conditions important to diagnose congenital pathology even at the stage of intrauterine development of the child. This is done using the ultrasound method, and the first study is indicated for all women up to 12 weeks of pregnancy. If the child has already been born with a hernia, it is necessary to perform a clarifying examination, which may include:
- X-ray.
- Computed tomography.
- Magnetic resonance imaging.
Additional diagnostic methods make it possible to assess the nature of the pathology, its prevalence, identify possible associations and differentiate with other conditions.
Treatment
A malformation of the spinal column can be judged by ultrasound diagnostic data during pregnancy. When determining splitting, additional studies are indicated - a large amount of alpha-fetoprotein indicates a presumptive neural tube defect. Amniocentesis is also performed - the study of amniotic fluid.
Unfortunately, this disease is practically untreatable. This is precisely the case when you need to take care in advance that it does not appear, since it is almost impossible to cure it completely.
In general, a patient with such a disease is constantly under the supervision of the attending physician, which is especially important for children in whom spina bifida is accompanied by hydrocephalus. To get rid of bladder problems, hygienic maintenance methods and a number of urological procedures are used.
To eliminate chronic constipation caused by problems in the rectum, a special diet is prescribed that includes a large amount of coarse plant fiber.
Some physiotherapeutic procedures partially help restore mobility, thanks to which a sick child can become completely independent. Otherwise you will need a wheelchair.
Intrauterine treatment of spina bifida is carried out only abroad. A fetal anomaly can be detected as early as 7-8 weeks; with the help of prenatal surgery at 19-26 weeks, you can get rid of the problem before the baby is born.
Surgical intervention
Removal of a hernia in newborns is carried out only surgically. A reconstruction of the spinal column is performed, and the unfused vertebrae are closed. Non-viable tissue of the hernial sac is excised, the rest is restored in the spinal canal. To avoid high intracranial pressure, shunting is performed - installing a shunt to drain cerebrospinal fluid into the thoracic lymph duct.
Conservative treatment options
Appropriate only as an additional measure to prevent complications and maintain general condition sick.
Treatment includes:
- taking medications to normalize the function of nervous tissue;
- vitamin therapy;
- physical therapy for motor function;
- a diet high in fiber.
Spina bifida is an anomaly that is very difficult to treat and has serious consequences. Therefore, it is very important for a woman to pay special attention to her health at the beginning of pregnancy, undergo the prescribed diagnostics in a timely manner, and take vitamin supplements (including folic acid). This will help minimize the risk of developing fetal pathologies and give birth to a healthy baby.
To achieve a positive effect in the treatment of spina bifida, it is necessary to begin therapy in the first days after the birth of the child. In this case, it should be noted that the operation should be performed by a surgeon with extensive professional experience, since any mistake can lead to spinal cord injury and irreversible consequences in the development of the child.
Surgical intervention involves complete removal a saccular neoplasm, after which the spinal cord begins to return to its normal anatomical position. The cleft is closed by plastic surgery.
If a child is diagnosed with spina bifida, the only treatment option is surgery. It is prescribed as soon as possible, preferably in the first week after birth.
Perinatal surgery
Postpartum surgery
If neural tube defects in the fetus are detected by prenatal screening, the question of terminating the pregnancy is raised in order to avoid the birth of a child with severe pathologies.
Consequences
Total messages: 134
03/23/2015, Sysoev Kirill Vladimirovich Treatment of children with consequences of spina bifida: http://spinabifida.su/
12/24/2014, Svetlana I wish strength and patience to everyone who is faced with the problem of spina bifida. My daughter is now 3 years old.
She was operated on for SMG on the 2nd day of life at the Tushino Hospital in Moscow. The forecasts were still the same.
The feet were flaccid, the legs did not move well at all, even at the hip. I couldn’t poop myself for a long time.
At the moment, the child walks, talks, usually poops on his own, feels the urge to urinate, although sometimes he does not have time to run. Feels his feet normally.
What did I do? I visited an osteopath - it’s expensive, but it helps, and I need to go once a month. Perhaps osteopathy turned out to be the most effective remedy.
Every day I stretched the child’s legs and feet, while always reading poems and nursery rhymes - always the same words for the same movement. I carried the child in my arms a lot and talked to her a lot.
I did massage and physical therapy, but I wouldn’t say it helped much. I went to the pool with my child.
This is great. I tried not to see doctors too often.
Regularly visited orthopedists. The most important thing: I put a lot of effort into believing all the time with all my soul that my child is healthy, will walk soon, will speak soon, everything is fine with my child and all impaired functions will be restored.
And don’t allow yourself to think that it will be different. I believe that this is most important, because the child always tries to live up to the expectations of his parents in everything.
Expect that your child will recover, believe in it, find confirmation of it - and the results will be better. Continue to believe, and be determined to improve even if everything seems hopeless.
For adults who had spina bifida in childhood, I can recommend osteopathy and classes according to the Feldenkrais or Thomas Hanna method (Hannah Somatics). Books can be downloaded for free on the Internet and studied from them.
Truly amazing, very simple and effective techniques, I highly recommend reading them. Good luck and ease to you all.
Remember, your confidence that everything will be fine works real miracles.
Prevention
Since spina bifida is congenital anomaly development, prevention of this disease is the elimination of its causes even before conception. The primary measure is to provide the unborn child with all the necessary microelements and vitamins.
Even if the pregnancy is unplanned, the use of medications and appropriate foods can be started after conception - the sooner the better. In the specific case of preventing spinal cord herniation, the emphasis is on vitamin B9 (folic acid).
It is interesting that this substance can enter the fetus’s body not only from the mother, but also from the future father, since it is transmitted through the seminal fluid, having a significant effect.
Any expectant mother should contact a gynecologist and consult about diseases that develop during the fetal development stage. The doctor should talk about ways to ensure a favorable pregnancy.
To begin, stop taking most pharmaceutical drugs for at least the first eight weeks while the neural tube forms in the embryo. Also, don’t get carried away with cosmetics; the same goes for any household chemicals.
Let us recall that the normal formation of the neural tube in the fetus completely depends on the adequate supply of necessary microelements and minerals to the mother’s body.
Therefore, the basis of prevention is always the use of vitamin complexes and the intake of folic acid in the first weeks after conception.
It can also be noted that it would be ideal to take folic acid before planning conception. It is important to emphasize that folic acid, like
the main component of prevention should be taken not only by the expectant mother, but also by the expectant father.
To get acquainted with this remedy, you can study the material - Folic acid for conception. which will help you correctly understand the full significance of this drug in planning a future pregnancy.
In the first weeks after conception, a woman should avoid taking any pharmaceutical drugs without consulting a doctor; in addition, it will be necessary to reduce contact with cosmetics and household chemicals.
Particular attention should be paid to the fact that after the 20th week of pregnancy, almost all the child’s organs are already formed, and during this period the main thing is not to harm the child in its intrauterine development.
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megan92 2 weeks ago
Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!
Daria 2 weeks ago
I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are
megan92 13 days ago
Daria 12 days ago
megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.
Sonya 10 days ago
Isn't this a scam? Why do they sell on the Internet?
Yulek26 10 days ago
Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars
Editor's response 10 days ago
Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!
Sonya 10 days ago
I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))
Margo 8 days ago
Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...
Andrey A week ago
Which ones folk remedies I didn't try, nothing helped, it only got worse...
Ekaterina A week ago
I tried drinking a decoction of bay leaves, it didn’t do any good, I just ruined my stomach!! I no longer believe in these folk methods - complete nonsense!!
Maria 5 days ago
I recently watched a program on Channel One, it was also about this Federal program to combat joint diseases talked. It is also headed by some famous Chinese professor. They say that they have found a way to permanently cure joints and back, and the state fully finances the treatment for each patient
Spinal diseases, including intervertebral hernias, are unfortunately not such a rare phenomenon. These diseases greatly reduce the child’s quality of life and affect his overall well-being, performance and learning.
The degree of severity of organic lesions in intervertebral hernias can be completely different - accordingly, the nature of the pain and loss of ability to work can also be very different - from mild health problems and periodic pain to severe damage to the spine, severe pain and complete loss of the child’s ability to move.
What leads to the formation of intervertebral hernias in children and adolescents?
- Injuries, blows to the spine, falls.
- Strength sports, excessive stress on the spine.
- Insufficient development of the child’s muscle corset, skeletal bones and connective tissue.
- Strong flexion and twisting of the spine in games or sports - for example, in gymnastics, somersaults, etc.
- Weakness of the body due to poor nutrition, sedentary lifestyle, environmental factors, and previous illnesses.
- Anatomical and genetic factors.
- Underweight or overweight.
What is an intervertebral hernia? The main symptoms and signs of intervertebral hernia in children and adolescents
In children, intervertebral hernia most often forms after many years of sports or excessive stress on the spinal column, and is accompanied by deformation of the disc between the vertebrae. As a result of rupture of the fibrous ring, the contents of the disc protrude into the lumen of the spinal canal, compressing the spinal cord or its root.
It should be noted that most symptoms of intervertebral hernia are associated with the location of the hernia on a particular segment of the spine.
1. If the intervertebral hernia is localized in the lumbar spine, then pain will be observed in the lumbar region. A small hernia produces minor and intermittent dull painful sensations in the spine, which can intensify with physical or static loads, sharp turns of the body. A large hernia in the lumbar region gives severe shooting pains that radiate to the groin, thigh, and buttock.
2. If a hernia is present, there may be numbness in areas of the skin of the body below the affected segment of the spine, weakness in the limbs, and tingling in the legs.
3. With frequent pain, the patient’s posture may change, curvature of the spine, and tension in the back muscles may occur.
4. For lesions in cervical spine spine, a child may experience pain in the cervical spine with irradiation to upper limbs, headaches in the occipital region. Sometimes there is numbness distal sections hands, dizziness, weakness, fatigue.
5. Intervertebral hernia in the thoracic spine is accompanied, first of all, by back pain. They can often be accompanied by pain in the heart area, under the scapula and intercostal neuralgia.
Intervertebral hernias often cause symptoms, for which correct differential diagnosis is especially important.
Basic methods for diagnosing intervertebral hernia in pediatric patients
Diagnosis of intervertebral hernia is the responsibility of orthopedists or neurosurgeons. An X-ray image shows an accurate diagnosis for this disease in very rare cases, therefore, in addition to radiography, it is necessary to resort to modern methods diagnostics – computed tomography, magnetic resonance imaging. The specialist must identify not only the presence of one or more intervertebral hernias, but also assess their size and exact location relative to the surrounding tissues - the spinal cord, nerves, and the discs themselves. These types of diagnostics allow you to get an idea of the structure of the spine in all segments, as well as complications of intervertebral hernia and concomitant diseases of the child.
But to draw up the correct treatment plan for the patient childhood with intervertebral hernia it is not enough above methods diagnostics, albeit the most modern ones. The doctor must take into account the nature of the clinical manifestations of the disease in the child as a result of compression of the spinal cord or its roots. The specialist must also in each case study the history of the formation of intervertebral hernia, the presence concomitant diseases child, the presence of other factors that in one way or another influence the formation of intervertebral hernias in a small patient.
