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
Aakash Healthcare Super Speciality Hospital
Delhi, India
Aakash Healthcare Super Speciality Hospital located in New Delhi, India is accredited by NABH. Also listed below are some of the most prominent infrastructural details:
- One of the biggest tertiary care hospitals in India
- Facility is fusion of state of the art technology, competent clinicians, and world-class infrastructure
- 230 beds
- 70 bedded medical and surgical and Critical Care Unit
- Ward Bed Options- Twin, Deluxe, Sharing and Economy
- Pneumatic Tube System
- Ambulance Services 24x7
- 15 Bedded dialysis unit
- Advanced Neonatal ICU
- Advanced imaging services, including magnetic resonance imaging, computed tomography scanning, digital mammography, ultrasound
- 8 modular OTs
- Flat Panel Cath Labs
- LASIK - SMILE Suite
- Wellness Lounge
- State-of-the-art diagnostic equipment
- 15 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
- Airport Pick-up and Drop
- Accommodation and Food for Attendant
- Language Interpreter Services
- 4 triage beds, a dedicated sample collection room, 6 observation beds, and highly skilled emergency staff
- Robotic knee replacement surgery
- ATM
- Lounge for visitors
- Internet Access: The whole facility is Wi-Fi enabled
- Travel Desk: Provides an all-round patient care.
- 24x7 pharmacy
Aster Medcity
Kochi, India
- 670 bed facility
- 24 hours Emergency and Trauma Care
Aster Centres of Excellence
- Cardiac Sciences
- Orthopaedics & Rheumatology
- Neurosciences
- Nephrology & Urology
- Oncology
- Gastroenterology
- Integrated Liver Care
- Womens Health
- Child & Adolescent Health
- Multi Organ Transplant
- Diagnostic Technology used for increasing the efficiency of diagnostic procedures.
- Streamlined Application of Therapeutic Technology
- Minimal Access Robotic Surgery (MARS) which makes use of the da Vinci Surgical System is applied by the specialists in Aster Medcity, Kochi, Kerala.
- ORI Fusion Digital Integrated Operation Theatres which applies Karlstorz OR1 Fusion system.
- Completely digital Anesthesia facility
- Pharmacy which possesses completely Automated Drug Dispensing
Pushpawati Singhania Research Institute
Delhi, India
Pushpawati Singhania Research Institute located in New Delhi, India is accredited by NABH, NABL. Also listed below are some of the most prominent infrastructural details:
- Multi-bed hospital with state-of-art infrastructure
- Advanced medical equipment
- High-tech labs
- Modular operation theaters
- Cath labs with Clarity Platform, 128 channel CARTO 3 version 4 with ICE mapping facility, FD 10 Prucka 2D EP system
- High-end Intensive Coronary Care Unit
- Dedicated Pre-Post Cath Unit
- Multislice CT Scan, 1.5 Tesla MRI
- 24 *7*365 functional cardiac Cath lab & operation theatre
- Fifteen bedded Coronary Care Unit
- 3D, 4D Echo & Trans-oesophageal Echo, Non Invasive cardiology (Holter, TMT, Echo, 24hrs ambulatory BP Monitoring
- Radio Frequency Ablation like Complex Arrhythmia such as ischemic VT, AF with 3 D Mapping imaging
- RFA using ICE Intra-cardiac Echo
- Well-equipped inpatient and intensive care services
- Ultra-modern Blood Bank Facility
- Advanced Physiotherapy center, 24/7 Emergency &Trauma services
- Gastroenterology department equipped with Capsule endoscopy, Endoscopic retrograde cholangiopancreatography, Single balloon enteroscopy, High resolution esophageal and anorectal manometry, Endoscopic ultrasound, and hydrogen breath test
Sustained low-efficiency daily dialysis and Continuous Renal Replacement Therapy - Exhaled Nitric oxide (FeNO) and allergy testing for the management of asthma
- Conventional PAP/ Liquid PAP/ HPV-DNA test for the patients with the High risk of cervical cancer
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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.