TREATMENT PROTOCOL FOR NEUROLOGIC CONDITION
Condition: SPINA BIFIDA
What is a spina bifida?
Spina bifida: is defect that occurs in the vertebral column where neural tubes of the spinal cord fail to close over the centre of the tube of nerves, exposing the
meninges and / or the spinal cord . As a result there are neurologic deficit to the lower limbs.
VARIES FORMS OF SPINA BIFIDA
 Rachischisis: completely open spine with severe neorologic disability and death
 Myelocele: spinal cord protrudes
 Myeningocele : protruding sac contains meninges
 Myelomeningocele : both the spinal cord and the meninges
CAUSES, INCIDENCE AND SCREENING
There is neither single cause of spina bifida nor any known way to prevent it entirely.
Scientists suspect genetic, nutritional, and environmental factors play a role. Research studies indicate that insufficient intake of folic acid a common B-vitamin
in the mother’s diet is a key factor in causing spina bifida and other neural tube defects.
Spina bifida is one of the most common birth defects, with an average worldwide incidence of 1-2 cases per 1000 births.
PREGNANCY SCREENING
 AFP blood screening
 Fetal ultrasound
 Genetic counseling and genetic testing ( amniocentesis) / Trisomy 18
Symptoms
Symptoms vary form person to person depending on the type of spina bifida and the level in which it occurs
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fluid filled sac at the back visible from the spine
an abnormal tuft or clump of hair or a small dimple or birthmark on the skin at the back
lower limb paralysis or weakness
loss of sensation to lower limbs
dislocated hips
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urinary and or bowel incontinence
club foot
hydrocephalus
scoliosis
poor eye-hand co-ordination
learning difficulties
contractures
TREATMENT
There is no cure for spina bifida. However dietary supplementation with folic acid (folate) has shown to help prevent spina bifida.
The nerve tissue that is damaged or lost cannot be repaired or replaced, nor can function be restored to the damaged nerves. Treatment depends on the type and
severity of the disorder. It requires a multi-disciplinary approach. Generally, children with the mild form need no treatment, although some may require surgery
as they grow (to close the defect) or for a shunt incase of hydrocephalus. Club foot can be corrected.
PHYSIOTHERAPY TREATMENT
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Assessment and/or Identification of all impairment associated with spina bifida
Assisting child to gain independency
Exercises for strength, balance and muscle control
Provision of assistive devices to where they needed
Bowel and bladder management
Helping Prevent and correction of contractures
at childhood development
Referring for Surgery and Orthopedic correction
Prevention of pressure sores
Prevention of secondary complications as a result of spina bifida
Regular checking of the skin and carefully positioning of lower limbs to minimize injuries due to loss of sensation.