Spina Bifida Treatment in India
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What is Spina Bifida?
A condition known as spina bifida is caused by a failure to form the spinal cord and spine correctly. This is a form of neural tube defect. In the embryo, the neural tube is the structure that will eventually become the baby's brain, spinal cord, and other surrounding tissues.
The neural tube usually closes by the 28th day after conception, having formed early in pregnancy. However, in spina bifida, some of the neural tube fails to close completely, affecting the spinal cord and the spine's bones.
What is the Importance of Timely Treatment?
Early treatment of spina bifida can reduce impairment, prevent infection and hydrocephalus, and improve cognitive and emotional development. Early therapies for controlling symptoms and improving quality of life include surgical interventions, physical therapy, and support. Early intervention can improve overall results and enable people with spina bifida to live active, fulfilling lives.
What are the Common Symptoms of Spina Bifida?
The common symptoms of spina bifida depend on the location and severity of the defect. In general, they include:
- Physical Disabilities: Paralysis of the legs partially or wholly depends on the severity and location of the defect.
- Hydrocephalus: Fluid accumulation in the brain brings about an elongated head and increased pressure inside the cranium.
- Bowel and Bladder Problems include loss of control of bowel and bladder functions, such as incontinence, constipation, or urinary retention.
- Deformities: Abnormal curvature or deformity in the spine in the back.
- Learning/Cognitive Challenges: Mild and moderate learning disorders, according to the level of the malformation.
Causes and Risk Factors of Spina Bifida
Causes
Spina bifida has no established aetiology. It is thought to be caused by a combination of environmental, dietary, and genetic risk factors, including a family history of neural tube abnormalities and inadequate folate (vitamin B9) during pregnancy.
Risk Factors
- Genetic Factors: A family history of spina bifida or other neural tube defects may increase the risk, and some genetic changes may also be implicated.
- Folic Acid Deficiency: The most significant risk factor is having a diet that lacks adequate amounts of folic acid (vitamin B9) both before and during the first trimester of pregnancy. Folic acid can prevent spina bifida and other neural tube defects.
- Health of the Mother:
- Obesity: The risk is higher if the individual is obese or overweight before conception.
- Diabetes: The possibility of spina bifida may be higher if the mother's diabetes is not well-controlled during pregnancy.
- Medications: Certain medications taken by pregnant women may increase spina bifida risk, especially those used to control epilepsy, such as anticonvulsants.
- Mother’s Age: A woman who is older than 35 years stands at a somewhat higher risk of delivering a child with spina bifida.
- Environmental Factors: Exposure to excessive heat (e.g., hot tubs or saunas) may increase the risk during early pregnancy.
- History of Previous Pregnancy with Spina Bifida: If a mother has had a previous child with spina bifida, the risk is higher for future pregnancies.
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Latest Research and Technologies in the Treatment of Spina Bifida in India
According to the study, innovative treatments, such as using placental stem cells during fetal surgery, are being investigated. This strategy attempts to restore spinal cord damage before birth, potentially reversing paralysis and other spina bifida-affected functions.
Spinal Bifida Prevention Tips
To reduce their risk of spina bifida, women should take folic acid daily during the early period of pregnancy and even before conception. Other helpful measures include avoiding certain medications, managing diabetes and obesity, and eating a healthy diet rich in folate. Preventing alcohol, tobacco, and excessive heat exposure should also help maintain a healthy lifestyle. Routine antenatal visits assure early diagnosis and thus allow early interventions. If these interventions are taken, the possibility of having a baby with spina bifida significantly decreases.
Treatment options for Spina Bifida
Surgery for Spina Bifida: Surgery for spina bifida is possible before delivery, as prenatal surgery, and after delivery.
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VP Shunt: Hydrocephalus (occurs together with spina bifida) treatment can be an implanted shunt that removes excessive fluid from the brain.
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- Clinical assessment:
Blood Test: Most cases of spina bifida are diagnosed by ultrasound examination during pregnancy, although blood tests may occasionally be used for screening purposes.
MSAFP test (Maternal serum alpha-fetoprotein): This measures the level of alpha-fetoprotein (AFP), a protein produced by the baby, obtained from a blood sample. Even though slight amounts of AFP regularly move from the baby into the pregnant parent's bloodstream, high levels may be indicative of a neural tube defect known as spina bifida. Usually, various factors can lead to increased levels of AFP, and it's not necessarily linked to spina bifida.
AFP levels: Other reasons why the AFP level may not be the same in all cases are that there could be more than one baby, or the AFP level may have been estimated inaccurately. A repeat blood test might be necessary to confirm the result. If your AFP levels are still high, you need further tests, like an ultrasound scan.
- Imaging Tests:
- Ultrasound: Ultrasound is often used to visualise the spinal defect and monitor any fluid accumulation (hydrocephalus) or anomalies in the spinal cord to diagnose fetal spina bifida. It also helps determine the severity of the defect before delivery.
- Other diagnostic:
- Amniocentesis: If the prenatal ultrasound confirms the diagnosis of spina bifida, the doctor might ask for the amniocentesis test. This involves taking a sample of fluid surrounding the baby from the amniotic sac using a needle. This examination may be crucial for a doctor to rule out hereditary illnesses.
MediRehab (chain of Rehab centres - Part of MediGence) provides comprehensive rehabilitation services designed to support spina bifida patients in India. These services include:
Physical Therapy: The main goals of physical therapy in spina bifida are strengthening muscles, increasing mobility, and improving posture, balance, and coordination. Physical therapy will help people achieve excellent function and independence by giving them specific exercises designed to improve movement and strategies for treating joint abnormalities or contractures.
- Depending on the situation, your healthcare professional may prescribe medicine to help control your symptoms and support the treatment plan.
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Hospitals for Spina Bifida in India
Bai Jerbai Wadia Hospital for Children
Mumbai, India
Bai Jerbai Wadia Hospital for Children located in Mumbai, India is accredited by AAAHC. Also listed below are some of the most prominent infrastructural details:
- There are two parts of the hospital, one is focused on women's care and the other is focused on child care.
- Bai Jerbai Wadia hospital for Children
- 300 bed capacity
- 60 Pediatricians
- 10,000 in-patients (annual)
- 100,000 outpatients (annual)
- Biggest Neonatal ICU (West zone)
- Nowrosjee Wadia Maternity Hospital
- Obstetrics and Gynecological disciplines (several)
- 20 specialists
- 305 bed capacity
- It is also a referral centre for women who are rehabilitating as well as their families.
VPS Rockland Hospital
Gurgaon, India
VPS Rockland Hospital located in Gurugram, India is accredited by NABH, NABL. Also listed below are some of the most prominent infrastructural details:
- Well-designed compact 103-bed hospital expanding over120,000 square feet
- Well equipped modular operation theatres, intensive care unit, interventional Cath lab, and in-patient rooms ranging from economy to luxury
- Offers a bouquet of services like Internal Medicine, Obstetrics & Gynaecology, Surgery, Pediatrics
- High-end diagnostic services like 1.5 T MRI and 128 slice CT Scan
- Advanced non-invasive assessment with echo & TMT machines
- State of the art cardiac Cath-Lab
- Appointment Scheduling
- Treatment packages
- Accommodation arrangement for the accompanying attendant
- Customized diet for patient and attendant
- Laundry services
- Prayer room
- Visa assistance
- Pick and drop facility from/to the Airport
- Foreign exchange facility
- Registration with the Foreigners Regional Registration Office
- Dedicated Neuro-Intensive care unit managed by expert intensivists
- Accommodation arrangements post discharge
- Highly advanced instruments for deep brain stimulation, stereotaxy, micro-neurosurgery, pediatric neurosurgery & neurophysiology
- Most advanced dialysis machines and advanced diagnostic and therapeutic facilities
- Renal replacement therapy for hemo-dynamically unstable patient
- Technologically advanced endoscopy suite
- Wi-Fi/internet service in the room
- Travel arrangement for patient & attendant post discharge
- Tele-consults post discharge
- Dialysis beds
- 24x7 ‘Trauma & Emergency Center
- Dedicated blood bank
- 24x7 comprehensive patient care.
- Deployed high-end technologies & smart digital system
- Robust Hospital Information Systems to meet complex medical needs of patients
- Robotic-assisted surgeries
- International Patients Lounge
The Madras Institute of Orthopedics and Traumatology
Chennai, India
MIOT started its journey with only 70 beds and focusing on Orthopedics and Trauma care. However, we grew into a multi-specialty hospital with time. MIOT is now a 1000-bedded hospital and can offer an extensive range of services across 63 specialties. The state of art laboratory of our hospital is ranked 8th internationally. We have 21 super-specialty operation theaters equipped with cutting-edge technology to help our doctors with complex procedures.
We take great care to make our patient rooms comfortable enough. The patient rooms get plenty of fresh air as well as natural light. The soothing views from the rooms do not let the patients feel cut off from the outside world. We use separate entrances for emergency patients, out-patients, in-patients, and their attendants. We put our patients’ safety first which is why we use a superior air system to ensure a near-zero infection healthy environment.
Apart from that, MIOT’s 24 hours blood bank provides all kinds of blood work related services which include blood collection to component separation. This state-of-art blood bank alone handles more than 30,000 units of blood over the course of a year. Every month around 600 blood transfusions are managed by this blood bank.
MIOT’s SIGNA Pioneer 3T MRI machine is made with noise reduction technology. This silent MRI machine can deliver superior quality neuroimages without wasting any time. The department of Radiology and Imaging Sciences can give tough competition to any international hospital with its advanced technology and accuracy.
The PET CT service at MIOT International is the first of its kind in South India enabling better and more accurate diagnosis than earlier. The superior diagnosis is also possible for the two digital cath labs at MIOT Heart Revive center.
We also have a physiotherapy team where a team of highly efficient physiotherapists deals with the mobility and functional disability issues of our patients. They listen to the patients carefully to identify the root of the pain and use therapeutic exercises to reduce their pain.
The CCU of MIOT is something to be proud of. The specially-trained staff of this unit is dedicated to ensuring top-quality medical support to serious patients. This unit along with the MIOT International Laboratory is the backbone of our facility.
Furthermore, what makes MIOT unique is our Telemedicine service. In the new normal, we are trying everything to reach our patients. Our one of its kind Telemedicine service connects our patients to our 250 full-time doctors over email, phone, chat and video consultations.
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Why Choose India for Spina Bifida Treatment?
India is an excellent destination for spina bifida treatment due to its state-of-the-art medical facilities, qualified medical professionals, and relatively affordable treatment options. The country provides comprehensive rehabilitative services and advanced medical techniques, including fetal surgery for spina bifida. Many Indian hospitals are internationally accredited, ensuring high standards of care. India is also a low-cost option for anyone seeking high-quality care, as treatment costs are significantly lower than in Western nations.
Frequently Asked Questions
PSpina bifida might impact a child's development in several ways, including physical impairments, weakness or paralysis of the muscles, especially the legs, and problems with mobility. It could also cause neurological disorders, including loss of sensation and cognitive impairment. Bowel and bladder control issues are common, but hydrocephalus can affect brain development.
Advances in medical care have significantly improved the life expectancy of individuals with spina bifida. Many people with the illness survive into adulthood, especially if they are given the proper care and attention for related issues like hydrocephalus. With continued treatment, many people with spina bifida enjoy happy, fulfilled lives. However, life expectancy may vary based on the illness's severity and other health conditions.
Yes, with the proper support and care, many people with spina bifida can lead everyday lives. However, due to the degree of their conditions, they may face neurological and physical challenges. As long as they receive proper medical care, rehabilitation, assistive technology, and support, people with spina bifida can be self-sufficient, attend school, and have social lives.
Spina bifida currently has no known treatment. Numerous medical techniques, such as surgery to fix the spinal deformity, physical therapy for improving movement, and other treatments that address connected issues, like hydrocephalus, can be used to manage the disease.
The aims of spina bifida treatment are the management of symptoms, prevention of complications, and improvement in quality of life. These include:
- Surgery: The operation is carried out within days after birth to close the spinal deformity and prevent further damage. Fetal surgery is sometimes carried out to correct the problem before delivery
- Physiotherapy: It prevents contractures and enhances muscle strength and movement
- Assistive Devices: Assistive mobility helps with bracing, splinting, and wheelchairs
- Hydrocephalus Treatment: Hydrocephalus treatment can be an implanted shunt that removes excessive fluid from the brain.
- Bladder and Bowel Management: Catheters, drugs, and surgery are administered to manage incontinence issues.
Yes, diagnostic testing and prenatal screening can identify spina bifida before delivery. The most common tests used are MSAFP testing, ultrasound, and amniocentesis.
Depending on the severity, spina bifida can have various long-term effects, but most commonly includes neurological impairments like sensory loss or learning challenges, as well as movement problems such as paralysis or weakness in the legs. Most have joint abnormalities, hydrocephalus requiring a shunt, and bladder and bowel dysfunction.
Yes, spina bifida can lead to learning problems in many affected children, particularly in the more severe types of the condition. Mild to moderate cognitive impairments may affect memory, attention, problem-solving, and processing speed.
Hydrocephalus occurs when the brain's cerebrospinal fluid accumulates so much that it raises the pressure inside the skull. It often occurs together with spina bifida, mainly when myelomeningocele, the most severe type, is present. Spina bifida's anomalies in the brain's fluid drainage system can cause the accumulation of CSF.
Hydrocephalus is a condition in which extra fluid in the brain causes damage if not treated. It is usually treated with a shunt, a tube placed into the brain to remove the extra fluid. It is essential to monitor individuals with spina bifida, as it can lead to physical signs such as head enlargement, learning disabilities, and developmental delays.