question: I was born with spina bifida but don't actually know what it is, mind explaining?
comment: You have a nervous system in your body. It consists of your brain, your spinal cord, and a bunch of small nerves that go to all the different parts of your body. Your spinal cord is surrounded by a bunch of bones called vertebrae. These vertebrae are stacked on top of each other and protect the spinal cord from damage. It's like how your rib cage protects your heart and lungs. When you were in your mother's belly, one of the vertebrae did not fully close in the back. If it was a small gap, it's not a big deal and it affects 10-20% of the population. If it was a big gap, part of your spinal cord could actually float outside your spinal column. There are several factors that cause this, but an important one is a folate deficiency. Folate (aka vitamin B9 or folic acid) is put into prenatal vitamins for women who are thinking about getting pregnant, and is commonly added to many different kinds of food like cereal. The catch is that spina bifida happens early in a pregnancy, often before a woman finds out she's pregnant and starts taking folate.
passages: Spina bifida, or myelomeningocele, is a type of open neural tube defect that can occur with problems with the early development of a fetus. Most researchers believe that both genetic and environmental factors (such as diet) play a role. During the first 28 days of a pregnancy, the brain and spinal cord form in the developing fetus. The causes of human Spina bifida are not proven. The majority of babies with open spina bifida have a variety of medical problems including nerve damage and problems with motor function, this may include some amount of paralysis of the lower part of their body (this ranges from very mild to quite severe), loss of control of their bowels and bladder, and abnormalities of the brain. Closed spina bifida is probably more common than is currently recognised and includes a range of subtle abnormalities where the neural tube is closed. This is sometimes referred to as spina bifida occulta.
   About 15% of people have spina bifida occulta. Rates of other types of spina bifida vary significantly by country from 0.1 to 5 per 1000 births. On average in developed countries it occurs in about 0.4 per 1000 births. In the United States it affected about 0.7 per 1000 births, and in India about 1.9 per 1000 births. Part of this difference is believed to be due to race, with Caucasians at higher risk, and part due to environmental factors.
   Section::::Signs and symptoms.:Neurological problems.:Executive function.
   Spina bifida does not follow direct patterns of heredity as do muscular dystrophy or haemophilia. Studies show a woman having had one child with a neural tube defect such as spina bifida has about a 3% risk of having another affected child. This risk can be reduced with folic acid supplementation before pregnancy. For the general population, low-dose folic acid supplements are advised (0.4 mg/day).
  
  Section::::Prevention.
   Myelomeningocele (MMC), also known as meningomyelocele, is the type of spina bifida that often results in the most severe complications and affects the meninges and nerves. In individuals with myelomeningocele, the unfused portion of the spinal column allows the spinal cord to protrude through an opening. Myelomeningocele occurs in the third week of embryonic development, during neural tube pore closure. MMC is a failure of this to occur completely. The meningeal membranes that cover the spinal cord also protrude through the opening, forming a sac enclosing the spinal elements, such as meninges, cerebrospinal fluid, and parts of the spinal cord and nerve roots. Myelomeningocele is also associated with Arnold-Chiari malformation, necessitating a VP shunt placement.
   Physical signs of spina bifida may include:
  
  BULLET::::- Leg weakness and paralysis
  
  BULLET::::- Orthopedic abnormalities (i.e., club foot, hip dislocation, scoliosis)
  
  BULLET::::- Bladder and bowel control problems, including incontinence, urinary tract infections, and poor kidney function
  
  BULLET::::- Pressure sores and skin irritations
  
  BULLET::::- Abnormal eye movement
   About 15% of people have spina bifida occulta. Rates of other types of spina bifida vary significantly by country, from 0.1 to 5 per 1000 births. On average in developed countries, including the United States, it occurs in about 0.4 per 1000 births. In India, it affects about 1.9 per 1000 births. Caucasians are at higher risk compared to Black people. The term is Latin for "split spine".
  
  Section::::Types.
  
  There are two types: spina bifida occulta and spina bifida cystica. Spina bifida cystica can then be broken down into meningocele and myelomeningocele.
  
  Section::::Types.:Spina bifida occulta.
   Women who have already had a baby with spina bifida or other type of neural tube defect, or are taking anticonvulsant medication, should take a higher dose of 4–5 mg/day.
  
  Certain mutations in the gene "VANGL1" have been linked with spina bifida in some families with a history of the condition.
  
  Section::::Screening.
   Extensive evidence from mouse strains with spina bifida indicates that there is sometimes a genetic basis for the condition. Human spina bifida, like other human diseases, such as cancer, hypertension and atherosclerosis (coronary artery disease), likely results from the interaction of multiple genes and environmental factors.
   Spina bifida is a birth defect in which there is incomplete closing of the spine and membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, meningocele and myelomeningocele. The most common location is the lower back, but in rare cases it may be the middle back or neck. Occulta has no or only mild signs. Signs of occulta may include a hairy patch, dimple, dark spot or swelling on the back at the site of the gap in the spine. Meningocele typically causes mild problems with a sac of fluid present at the gap in the spine. Myelomeningocele, also known as open spina bifida, is the most severe form. Associated problems include poor ability to walk, problems with bladder or bowel control, accumulation of fluid in the brain (hydrocephalus), a tethered spinal cord and latex allergy. Learning problems are relatively uncommon.
   Those who are white or Hispanic have a higher risk. Girls are more prone to being born with spina bifida.
  
  Section::::Pathophysiology.
  
  Spina bifida occurs when local regions of the neural tube fail to fuse or there is failure in formation of the vertebral neural arches. Neural arch formation occurs in the first month of embryonic development (often before the mother knows she is pregnant). Some forms are known to occur with primary conditions that cause raised central nervous system pressure, raising the possibility of a dual pathogenesis.
   In normal circumstances, the closure of the neural tube occurs around the 23rd (rostral closure) and 27th (caudal closure) day after fertilization. However, if something interferes and the tube fails to close properly, a neural tube defect will occur. Medications such as some anticonvulsants, diabetes, obesity, and having a relative with spina bifida can all affect the probability of neural tube malformation.
   In the United States, rates are higher on the East Coast than on the West Coast, and higher in white people (one case per 1000 live births) than in black people (0.1–0.4 case per 1000 live births). Immigrants from Ireland have a higher incidence of spina bifida than do natives. Highest rates of the defect in the USA can be found in Hispanic youth.
   Individuals with spina bifida may struggle academically, especially in the subjects of mathematics and reading. In one study, 60% of children with spina bifida were diagnosed with a learning disability. In addition to brain abnormalities directly related to various academic skills, achievement is likely affected by impaired attentional control and executive functioning. Children with spina bifida may perform well in elementary school, but begin to struggle as academic demands increase.
   Open spina bifida can usually be detected during pregnancy by fetal ultrasound. Increased levels of maternal serum alpha-fetoprotein (MSAFP) should be followed up by two tests – an ultrasound of the fetal spine and amniocentesis of the mother's amniotic fluid (to test for alpha-fetoprotein and acetylcholinesterase). AFP tests are now mandated by some state laws (including California). and failure to provide them can have legal ramifications. In one case, a man born with spina bifida was awarded a $2-million settlement after court found his mother's OBGYN negligent for not performing these tests. Spina bifida may be associated with other malformations as in dysmorphic syndromes, often resulting in spontaneous miscarriage. In the majority of cases, though, spina bifida is an isolated malformation.
   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. The skin at the site of the lesion may be normal, or it may have some hair growing from it; there may be a dimple in the skin, or a birthmark. Unlike most other types of neural tube defects, spina bifida occulta is not associated with increased AFP, a common screening tool used to detect neural tube defects in utero. This is because, unlike most of the other neural tube defects, the dural lining is maintained.
   To be specific, the study found that prenatal repair resulted in:
  
  BULLET::::- Reversal of the hindbrain herniation component of the Chiari II malformation
  
  BULLET::::- Reduced need for ventricular shunting (a procedure in which a thin tube is introduced into the brain's ventricles to drain fluid and relieve hydrocephalus)
  
  BULLET::::- Reduced incidence or severity of potentially devastating neurologic effects caused by the spine's exposure to amniotic fluid, such as impaired motor function
   Research has shown the lack of folic acid (folate) is a contributing factor in the pathogenesis of neural tube defects, including spina bifida. Supplementation of the mother's diet with folate can reduce the incidence of neural tube defects by about 70%, and can also decrease the severity of these defects when they occur. It is unknown how or why folic acid has this effect.
   In this type of neural tube defect, the meninges do not herniate through the opening in the spinal canal. By definition, "spina bifida occulta" means "hidden split spine". The most frequently seen form of spina bifida occulta is when parts of the bones of the spine, called the spinous process, and the neural arch appear abnormal on a radiogram, without involvement of the spinal cord and spinal nerves. The risk of recurrence in those who have a first degree relative (a parent or sibling) is 5–10 times greater compared to the general population.
  
  Section::::Cause.
  
  Section::::Cause.:Folate deficiency.
   Individuals with spina bifida, especially those with shunted hydrocephalus, often have attention problems. Children with spina bifida and shunted hydrocephalus have higher rates of ADHD than children without those conditions (31% vs. 17%). Deficits have been observed for selective attention and focused attention, although poor motor speed may contribute to poor scores on tests of attention. Attention deficits may be evident at a very early age, as infants with spina bifida lag behind their peers in orienting to faces.
  
  Section::::Signs and symptoms.:Neurological problems.:Academic skills.
   Spina bifida is believed to be due to a combination of genetic and environmental factors. After having one child with the condition or if one of the parents has the condition, there is a 4% chance that the next child will also be affected. Not having enough folate in the diet before and during pregnancy also plays a significant role. Other risk factors include certain antiseizure medications, obesity and poorly controlled diabetes. Diagnosis may occur either before or after a child is born. 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.
   The protruding portion of the spinal cord and the nerves that originate at that level of the cord are damaged or not properly developed. As a result, there is usually some degree of paralysis and loss of sensation below the level of the spinal cord defect. Thus, the more cranial the level of the defect, the more severe the associated nerve dysfunction and resultant paralysis may be. Symptoms may include ambulatory problems, loss of sensation, deformities of the hips, knees or feet, and loss of muscle tone.
  
  Section::::Signs and symptoms.
  
  Section::::Signs and symptoms.:Physical problems.
   Several studies have demonstrated difficulties with executive functions in youth with spina bifida, with greater deficits observed in youth with shunted hydrocephalus. Unlike typically developing children, youths with spina bifida do not tend to improve in their executive functioning as they grow older. Specific areas of difficulty in some individuals include planning, organizing, initiating, and working memory. Problem-solving, abstraction, and visual planning may also be impaired. Further, children with spina bifida may have poor cognitive flexibility. Although executive functions are often attributed to the frontal lobes of the brain, individuals with spina bifida have intact frontal lobes; therefore, other areas of the brain may be implicated.
    is Latin for "hidden". This is the mildest form of spina bifida.
   Spina bifida is a congenital disorder in which there is a defective closure of the vertebral arch. Sometimes the spinal meninges and also the spinal cord can protrude through this, and this is called "Spina bifida cystica". Where the condition does not involve this protrusion it is known as "Spina bifida occulta". Sometimes all of the vertebral arches may remain incomplete.
  
  Another, though rare, congenital disease is Klippel-Feil syndrome which is the fusion of any two of the cervical vertebrae.
  