Spina Bifida (cont.)
After newborn surgery, children with severe spina bifida undergo regular assessment to detect any deformities, developmental problems, or other complications that may require intervention.
- Children should be watched for signs of hydrocephalus, tethered spinal cord, seizure activity, obesity, bowel and/or bladder control problems, frequent urinary tract infections, learning disorders, emotional and psychosocial problems, and other complications of spina bifida.
- Care at a multidisciplinary spina bifida facility will allow the earliest possible detection of these complications, when treatment is most likely to be effective and prevent further deterioration.
The focus of treatment is developing strength, mobility, and independence. Many of these children will walk. For others, accessibility is the goal.
- Parents should work with a physical therapist to learn how to exercise the baby’s legs to maximize strength and movement. They should begin these exercises as soon after the first surgery as possible. This not only readies the child for walking, but also prevents osteoporosis due to disuse.
- Children with spina bifida should be provided with prolonged physical therapy, physical education, or adaptive training while in school.
- Many children can become mobile by wearing a brace or using crutches or an orthotic. These devices allow the child to function at the best possible level by helping with balance, posture, and control.
- Additional operations may be necessary to correct problems interfering with walking and other functions.
- Despite this assistance, some children with spina bifida will never be able to walk independently. These children will use a wheelchair for the rest of their lives.
Bowel and bladder disorders can cause not only physical problems, but also social problems due to teasing, rejection, and isolation.
- Children can be taught techniques for emptying their bladder and bowels appropriately and independently, thus avoiding embarrassment.
- For example, use of a plastic tube (catheter) to drain urine from the bladder on a regular schedule can help prevent overfilling, which can injure the kidneys. This technique, called clean intermittent catheterization, is of proven benefit in people with spina bifida.
Prevention and treatment of obesity is an important aspect of medical care for the person with spina bifida. Education and counseling concerning physical activity and dietary choices can help maintain weight at a healthy level.
Treatment for other complications of spina bifida depends on the nature of the complications. Medications, surgery, physical therapy, or behavioral therapy may be appropriate.
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