Holly
10-28-2007, 03:36 PM
Spina Bifida Occulta refers to a group of conditions involving the spinal column—a structure made of bones called vertebrae. The spinal column is responsible for supporting the skeleton and protects the spinal cord, which is the cable of nervous tissue that transmits information between the brain and the body. Spina Bifida Occulta is a common condition, occurring in 10% - 20% of otherwise healthy people; it is often found incidentally during a radiogram (X-Ray) of the lower back. By definition “Spina Bifida Occulta” means “hidden split spine.” The term is misleading because it is used to describe several conditions. The most frequently seen form is considered harmless and is simply a variant of normal vertebral (bone) anatomy. In this condition, parts of the bones of the spine called the spinous process and neural arch appear abnormal on a radiogram. Usually, the spinal cord, and spinal nerves are not involved. Isolated bony Spina Bifida Occulta (without an underlying spinal cord abnormality) does not lead to problems with the nervous system. Some radiologists have resorted to calling this situation a vertebral fusion defect, thus taking away the reference to Spina Bifida. However, those (much less common) related conditions also called Spina Bifida Occulta that affect the spinal cord and are the ones can have potential health consequences. These conditions include:
Condition & Definition:
Tethered spinal cord
The lower end of the cord has an abnormal attachment to surrounding structures. The spinal cord gets stretched and damaged
Lipomyelomeningocele and lipomeningocele
A tethered spinal cord attached to a benign fatty tumor in the back
Thickened filum terminale
A thickening in the end section of the spinal cord
Fatty filum terminale
A fatty lump at the inside end of the spinal cord
Diastematomyelia (split spinal cord) and Diplomyelia
A spinal cord split in two, usually by a piece of bone or cartilage
Dermal sinus tract (with involvement of the spinal cord)
A connection between the spinal canal and the skin of the back that appears as a band of tissue to the outside
These conditions may occur without bony abnormalities of the vertebrae. If any of these associated abnormalities of the spinal cord occur, signs and symptoms related to the nervous system may occur.
These signs and symptoms include:
Pain (in the back and /or legs)
Weakness in the legs
Numbness and/or other changes in sensation in the legs and/or back
Orthopedic deformities in the legs, feet, and back
Change in bladder or bowel functionIndividuals with the likelihood of an underlying spinal cord abnormality should receive prompt medical/surgical evaluation to prevent the neurologic problems listed above. How can individuals who might need this type of evaluation be identified? The appearance of the skin overlying the lower back provides clues as to whether or not there is likely to be a spinal cord abnormality present underneath. About 80% of people with spinal cord abnormalities will have some type of skin abnormality overlying the defect.
These skin defects include:
Hairy patch
Fatty lump
Hemangioma—a reddened or purplish spot on the skin made up of a collection of blood vessels
Dark spots or biri the blue-black marks called Mongolian spots
Skin tract (tunnel) or sinus—sometimes noted on the back as a deep dimple—especially if it is too high, i.e higher than the top of the buttocks crease, or if its bottom cannot be seen
Hypopigmented spot—an area with decreased skin colorPeople with these kinds of skin abnormalities of the lower back, whatever their age, should seek evaluation by a physician knowledgeable in malformations of the spinal cord. Not every person with a skin defect of the lower back has Spina Bifida Occulta. This is particularly true for those with sacral dimple. Studies such as an ultrasound (only useful in newborns) or MRI of the spine may be requested to evaluate the underlying structures.
One final issue regards the inheritance patterns of Spina Bifida Occulta as well as Spina Bifida in general. Myelomeningocele (or meningomyelocele), an open form of Spina Bifida (where the spinal cord abnormality is actually visible through an open skin defect), occurs more often in families who have already experienced this condition.
The risk of recurrence in those who have a first-degree relative (parent, sibling) is 5-10 times greater than that in the general population. The risk of having other forms of Spina Bifida, when a case of myelomeningocele has occurred already in the family, is probably higher than in the general population. However, the genetic risk of recurrence with symptomatic forms of Spina Bifida Occulta is uncertain. Medical evaluations and genetic/pregnancy counseling should be done on a case-by-case basis with knowledgeable professionals. In all circumstances, all women of childbearing age should consume 0.4 milligrams of folic acid daily.
This information does not constitute medical advice for an individual. As specific cases may vary from the general information presented here, SBA advises readers to consult a qualified medical or other professional on an individual basis.
SOURCE (http://www.sbaa.org/site/c.liKWL7PLLrF/b.2700275/k.5F64/Spina_Bifida_Occulta.htm)
Condition & Definition:
Tethered spinal cord
The lower end of the cord has an abnormal attachment to surrounding structures. The spinal cord gets stretched and damaged
Lipomyelomeningocele and lipomeningocele
A tethered spinal cord attached to a benign fatty tumor in the back
Thickened filum terminale
A thickening in the end section of the spinal cord
Fatty filum terminale
A fatty lump at the inside end of the spinal cord
Diastematomyelia (split spinal cord) and Diplomyelia
A spinal cord split in two, usually by a piece of bone or cartilage
Dermal sinus tract (with involvement of the spinal cord)
A connection between the spinal canal and the skin of the back that appears as a band of tissue to the outside
These conditions may occur without bony abnormalities of the vertebrae. If any of these associated abnormalities of the spinal cord occur, signs and symptoms related to the nervous system may occur.
These signs and symptoms include:
Pain (in the back and /or legs)
Weakness in the legs
Numbness and/or other changes in sensation in the legs and/or back
Orthopedic deformities in the legs, feet, and back
Change in bladder or bowel functionIndividuals with the likelihood of an underlying spinal cord abnormality should receive prompt medical/surgical evaluation to prevent the neurologic problems listed above. How can individuals who might need this type of evaluation be identified? The appearance of the skin overlying the lower back provides clues as to whether or not there is likely to be a spinal cord abnormality present underneath. About 80% of people with spinal cord abnormalities will have some type of skin abnormality overlying the defect.
These skin defects include:
Hairy patch
Fatty lump
Hemangioma—a reddened or purplish spot on the skin made up of a collection of blood vessels
Dark spots or biri the blue-black marks called Mongolian spots
Skin tract (tunnel) or sinus—sometimes noted on the back as a deep dimple—especially if it is too high, i.e higher than the top of the buttocks crease, or if its bottom cannot be seen
Hypopigmented spot—an area with decreased skin colorPeople with these kinds of skin abnormalities of the lower back, whatever their age, should seek evaluation by a physician knowledgeable in malformations of the spinal cord. Not every person with a skin defect of the lower back has Spina Bifida Occulta. This is particularly true for those with sacral dimple. Studies such as an ultrasound (only useful in newborns) or MRI of the spine may be requested to evaluate the underlying structures.
One final issue regards the inheritance patterns of Spina Bifida Occulta as well as Spina Bifida in general. Myelomeningocele (or meningomyelocele), an open form of Spina Bifida (where the spinal cord abnormality is actually visible through an open skin defect), occurs more often in families who have already experienced this condition.
The risk of recurrence in those who have a first-degree relative (parent, sibling) is 5-10 times greater than that in the general population. The risk of having other forms of Spina Bifida, when a case of myelomeningocele has occurred already in the family, is probably higher than in the general population. However, the genetic risk of recurrence with symptomatic forms of Spina Bifida Occulta is uncertain. Medical evaluations and genetic/pregnancy counseling should be done on a case-by-case basis with knowledgeable professionals. In all circumstances, all women of childbearing age should consume 0.4 milligrams of folic acid daily.
This information does not constitute medical advice for an individual. As specific cases may vary from the general information presented here, SBA advises readers to consult a qualified medical or other professional on an individual basis.
SOURCE (http://www.sbaa.org/site/c.liKWL7PLLrF/b.2700275/k.5F64/Spina_Bifida_Occulta.htm)