Dengan Nama Allah,yang tidak memberikan mudarat sesuatu di bumi dan juga di langit dan dia maha mendengar lagi maha mengetahui..

Tuesday, December 1, 2015

Physiotherapy and myelomeningocele



1.      Spina Bifida latin word for split spine.
2.      Most common group of birth defects called neural tube defects (NTD).
3.      The neural tube develops into the brain and spinal cord.

What is Spina Bifida?
       It’s a defect of the spine in a developing fetus, it affects the brain, spinal cord, and it’s muscles surrounding it, and resulting in loss of movement and or sensation to the legs and feet as well as bowel movement and bladder dysfunction.

When does Spina Bifida occur?
   The notochord is a column of cells that run up the length of the embryo between the ectoderm and endoderm. It plays an important role in inducing formation of the spinal cord and spinal column. The mesenchymal rods run down the length of the embryo form lateral to the notochord by the concentration of mesenchymal cells. The rods eventually break into 42-44 pairs of somites at sequential levels. Somites will form part of the vertebrae by migrating around the neural tube, other parts of the mesenchyme will form tissue such as muscle,posterior vertebral arch and ligaments behind the spinal cord.

Three forms of Spina Bifida
1.      Occulta-There is a small defect or gap in one or more vertebrae of the spine, most affected individuals have no problems.
2.      Meningocele-Rarest form a cyst consisting of membranes surrounding the spinal cord pokes through the open part of the spine. Can be removed surgically allowing for normal development.
3.      Myelomeningocele- Most severe form. The cyst holds both membranes surrounding the spinal canal, nerve roots of the spinal cord and often the cord itself. Sometimes it’s a fully exposed section of the spinal cord and nerves. Has to be closed surgically. In spite of surgery the problem of paralysis,bladder and bowel control still remain.

What causes Spina Bifida?
     Spina bifida is usually an isolated birth defect. Although scientists believe genetics and environmental factors act together to cause this, many babies born with spina bifida have no family history of this disorder. Women with certain chronic health problems such as diabetes and seizure disorders have an increased risk of having a baby with spina bifida especially if taking anticonvulcant medications. Approximately 1/100 of having a baby with spina bifida.

How Is Spina Bifida treated?
One way that Spina Bifida is being treated is by operating on the fetus while still in the womb. This procedure is done as if fetus is being delivered via cesarean section.
Another way is that it is usually treated surgically between 24 to48 hours after birth.

Can Spina Bifida be prevented?
Yes it can, studies have showed that women should take folic acid before and during pregnancy to avoid any neural tube defects.It is recommended that women take a multivitamin containing 400 micrograms of folic acid daily and foods that contain natural folic acid such as vegetables, grains, and orange and citrus juices.




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