The reported overall incidence of myelomeningocele in the British Isles was 2.0–3.5 cases per 1000 births. Since then, the rate has fallen dramatically with 0.15 per 1000 live births reported in 1998, though this decline is partially accounted for because some fetuses are aborted when tests show signs of spina bifida (see Pregnancy screening above). Research
1980 – Fetal surgical techniques using animal models were first developed at the University of California, San Francisco by Michael R. Harrison, N. Scott Adzick and research colleagues. 1994 – A surgical model that simulates the human disease is the fetal lamb model of myelomeningocele (MMC) introduced by Meuli and Adzick in 1994. The MMC-like defect was surgically created at 75 days of gestation (term 145 to 150 days) by a lumbo-sacral laminectomy. Approximately 3 weeks after creation of the defect a reversed latissimus dorsi flap was used to cover the exposed neural placode and the animals were delivered by cesarean section just prior term. Human MMC-like lesions with similar neurological deficit were found in the control newborn lambs. In contrast, animals that underwent closure had near-normal neurological function and well-preserved cytoarchitecture of the covered spinal cord on histopathological examination. Despite mild paraparesis, they were able to stand, walk, perform demanding motor test and demonstrated no signs of incontinence. Furthermore, sensory function of the hind limbs was present clinically and confirmed electrophysiologically.
Before birth, if a blood test or amniocentesis finds a high level of alpha-fetoprotein (AFP), there is a higher risk of spina bifida. Ultrasound examination may also detect the problem. Medical imaging can confirm the diagnosis after birth. Spina bifida is a type of neural tube defect related to but distinct from other types such as anencephaly and encephalocele.Most cases of spina bifida can be prevented if the mother gets enough folate before and during pregnancy. Adding folic acid to flour has been found to be effective for most women. Open spina bifida can be surgically closed before or after birth. A shunt may be needed in those with hydrocephalus, and a tethered spinal cord may be surgically repaired. Devices to help with movement such as crutches or wheelchairs may be useful. Urinary catheterization may also be needed.Rates of other types of spina bifida vary significantly by country, from 0.1 to 5 per 1,000 births. On average, in developed countries, including the United States, it occurs in about 0.4 per 1,000 births. In India, it affects about 1.9 per 1,000 births. Europeans are at higher risk compared to Africans. Types
Spina bifida occulta
Occulta is Latin for hidden. This is the mildest form of spina bifida. In occulta, the outer part of some of the vertebrae is not completely closed. The splits in the vertebrae are so small that the spinal cord does not protrude.