Infants with Spina Bifida should receive extensive physical therapy and massage to establish and maintain function, especially in the abdomen and legs. Adults with this birth defect can receive massage as long as their sensation is intact.
What is Spina Bifida?
Literally meaning “cleft spine,” Spina Bifida is a defect in which the vertebrae fail to close completely over the spinal cord. In severe cases, the neural tube is left completely open and the baby usually does not survive birth.
Spina Bifida occurs around once in 1000 live births. It is believed to have a genetic component as a family history of the condition raises the risk of having a child with it. European whites and hispanics have a higher incidence. Women with the condition, or who have diabetes or seizure disorders have an increased risk of having a child with Spina Bifida.
What causes it?
The condition develops between days 14 and 28 of pregnancy, generally before the pregnancy is discovered. The main risk factor is folic acid deficiency in the mother. This is why it is vitally important for women who wish to have children to be sure they are getting enough folic acid in their diets.
Types of Spina Bifida
- Spina Bifida Meningocele – the rarest type. The dura mater and arachnoid layers of the meninges press through the vertebral cleft, forming a visible cyst. This type is easily repairable with surgery and has few or no long-term consequences for the baby.
- Spina Bifida Myelomeningocele – most common and most severe type. The spinal cord or extensions of cauda equina protrude with the meninges through the cleft. In some cases, skin does not completely cover the defect, leading to a serious risk of infection.
- Spina Bifida Occulta – in this case the arch, usually in the lumbar region, partially fuses and there are no obvious signs or symptoms until puberty, when the child goes through a growth spurt that stretches the spinal cord. Problems usually manifest as problems in the feet or with bladder and bowel control.
The severity of the defect is determined by the location and size of the cyst or bulge of spinal cord tissue through the spine. The higher up on the spine the defect occurs, the more paralysis present.
Most children with Spina Bifida have normal intelligence; some experience mild to severe learning disabilities.
Many cases are corrected surgically, either in-utero (in the womb), or shortly after birth. Rigorous physical therapy and exercises to maintain function in the leg muscles and promote nerve stimulation is prescribed for most of the child’s early life.
As the child matures, their functional level becomes clear, and they may need crutches, leg braces, or wheelchairs.
Spina Bifida and Massage
As with most central nervous system disorders, massage is appropriate and effective when the patient has sensation and some functional use of their extremities. Massage can help maintain muscle tone and nerve patency.
Deep tissue techniques can be used to reduce contracture. Stretches and range of motion exercises, shiatsu, and reflexology are supportive. Swedish massage can be helpful as long as the patient is able to lie comfortably on the table. Trigger point therapy should not be used near the affected area of the spine, but is effective in other areas.