Gorovitz & Borten, P.C.
Attorneys at Law

550 Cochituate Road, Suite 25
Framingham, Massachusetts
Tel: (781) 890-9095
Spina Bifida
Spina bifida is the most common of a group of birth defects affecting the coverings
of the nervous system known as 'Neural Tube Defects' (NTD). They can range from
mild spina bifida (aperta) to the most severe anencephaly (absence of variable
amounts of brain). Malformations of the spinal cord and brain may be acquired
deformities or the result of a genetic mutation. They tend to occur early in the
process of fetal formation (embryogenesis) and some are incompatible with life.

Spina bifida can be diagnosed in one of three forms:

  • Occulta
  • Meningocele
  • Myelomeningocele

Spina bifida occulta is the mildest form of the disease. it involves a small defect in
one or more vertebra and the meninges (covering of the spinal cord) do not
herniate through the bony defect. The lesion is covered by skin getting its name
from hidden or occult. Evaluation by ultrasound or MRI can reveal the presence of
a tethered spinal cord which may require surgical repair before it causes significant
neurologic deficits.

Spina bifida with meningocele is simply a herniation of the meninges through the
bony defect. The spinal cord and nerve roots do not herniate into the meningeal
sac. Children with meningocele do not have associated neurologic malformations.
Surgical removal of the meningeal sac allows for normal subsequent development.

Spina bifida with myelomeningocele refers to the condition in which the spinal cord
and nerve roots herniate into the meningeal sac. The spinal cord is often fully
exposed. Affected infants have some degree of paralysis of the legs depending on
the level the myelomeningocele is located. urogenital abnormalities are usually
present as a result of the involvement of the sacral nerve roots. Surgery to close
the opening is the treatment of choice.

Common medical problems associated with spina bifida myelomeningocele include:

  • Hydrocephalus
  • Chairi II malformation
  • Syringomielia
  • Brainstem malformations
  • Cerebral ventricular abnormalities

Folic acid (a type of vitamin B) can help prevent the appearance of neural tube
defects (NTD). Folic acid must be ingested before a woman gets pregnant and
during early pregnancy. Because a large percentage of pregnancies are
unplanned, preconceptional ingestion of folic acid is not always possible. Diagnosis
of a neural tube defect (NTD) early in pregnancy then becomes essential.

Screening for neural tube defects (NTD) such as spina bifida is performed with
ultrasound and blood tests. Blood screening test involves the measurement of
some substances in the maternal blood along with maternal age and gestational
age. These tests have to be performed between 15 and 22 weeks of gestation to
increase the validity of the results. Measurement of alpha fetoprotein (AFP), human
chorionic gonadotropin (hCG) and unconjugated estriol (uE3) is known as 'Triple
marker'; the addition of the measurement of inhibin A increased the accuracy of the
results and is called "Quadruple marker'.

As with other screening tests, any abnormal results requires a confirmatory
diagnostic test. Amniocentesis to measure the alpha fetoprotein levels in amniotic
fluid in conjunction with a detailed ultrasound assists in the prenatal diagnosis of a
neural tube defect (NTD).

If your child suffers from spina bifida  and you were not given the option to undergo
screening, genetic counseling and/or genetic testing,
Dr. Borten and the  Boston
area medical malpractice attorneys at Gorovitz & Borten can help you assert your
rights and get the compensation you deserve.
Contact Information
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possible), please contact us by phone, fax or e-mail with your question or concern.

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