9658643-Spina Bifida

9658643-Spina Bifida - [Author's Name[Professor's...

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[Author's Name] [Professor's Name] [Course title] [Date] Spina Bifida Spina bifida is a condition which results from arrested foetal development, which occurs some time in early pregnancy at a stage when the nerve cord is being formed. The causes are not known but ‘genetic predisposition plays some part in aetiology as do intrauterine environmental factors’ (Carter, 1969). In England it is found in about two per 1000 births and it occurs more frequently in girls than in boys. Children suffering from this defect are born with a spine which is ‘bifid’ (i.e., split in two) and the tissues surrounding the nerve cord or even the cord itself are exposed on the surface of the body. Where the underlying tissues protude, a cyst or fluid-filled sac forms on the back. If this sac contains only the tissues which surround the nerve cord (the meninges) and not the nerve cord itself, then the defect does not usually cause any handicap. This less serious type of spina bifida, called meningocele, is not so common, causing handicap in less than 20 per cent of children with this condition. In myelomeningocele the spinal cord itself is abnormal and the nerves are exposed or lie close to the surface of the skin. These children have paralysis of some or all of the muscles which are controlled by the damaged portion of the spinal cord, and the muscles of the hips, legs and feet as well as those controlling bladder and bowel functions may be affected. Between a third and a half of the children with myelomeningocele are paraplegic, while most of the others have significant locomotor problems. Depending on the type of defect, the position of the defect on the spine, and the extent of the damage to the nerve cord, a child may be totally paralysed from the waist down or virtually normal in function.
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In addition, the child may have associated abnormalities either present at birth or arising later as a consequence of the damage present at birth, including abnormalities of the rib cage, scoliosis (when the spine is twisted sideways), kyphosis (curvature of the spine), dislocated hips, or other ‘fixed limb’ deformities of the ankles and knees. These ‘fixed limb’ defects occur because only the muscles on one side of the limb are paralysed (an imbalance of muscle power) resulting in the limb being pulled out of shape. Orthopaedic surgery may be necessary to help correct these deformities, the aim being to improve the balance of muscles pulling on a limb. Most surgery is carried out in the early years, but in the teens some final corrective surgery may be required. (Bergstrom- Walan, M.B. 43) Unlike children with cerebral palsy, however, the damage is not confined
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9658643-Spina Bifida - [Author's Name[Professor's...

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