SPINA BIFIDA: DIAGNOSIS AND TREATMENT APPROACHES IN CHILDREN

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SPINA BIFIDA: DIAGNOSIS AND TREATMENT APPROACHES IN CHILDREN

Early treatment in experienced centers for children in Turkey with spina bifida is the most important factor in reducing the problems that may be encountered in the future.

1- What is spina bifida?

Spine, on your 28. day pregnancy closes on the day and becomes a tube in which the spinal cord will develop. Spina bifida is a condition in which the bones of the spine do not close due to congenital reasons while in the womb, and the spinal cord located inside and the nerves coming out of here remain exposed. Spina bifida is one of the first causes of permanent disability in children in the United States, where health statistics are regularly kept.

Unfortunately, there is no healthy data on this issue in our country. The effect of genetic factors on the formation of spina bifida is known. Having a similar abnormality in the family increases the risk. Especially for pregnant women at risk, the use of folic acid for preventive purposes can prevent an abnormality that may occur.

2- How many types of spina bifida are there?

There are mainly two types of spina bifida: closed (hidden) spina bifida, in which the opening is covered with a membrane or skin, or completely open and open spina bifida, in which the spinal cord and the resulting neural structures protrude.

3- What is spina bifida?

Hidden spina bifida is not obvious from the outside. These patients are usually detected during radiological examinations performed for another reason. Sometimes there may be a slight pubescence or inward depression on the skin area where the opening is located. An abnormality in the functions of the nervous system is not detected in a very large proportion of these patients. In the other subtype, known as meningocele, there is an external opening, but this opening is closed by the natural membranes surrounding the spinal cord. When viewed from the outside, the membrane and the neural structures contained in it are visible. There is a low probability of disorders in the nervous system functions in these patients.

4- How is open spina bifida defined?

Open spina bifida, also defined as meningomyelocele, is the most severe type. The bone structure is open, and the neural structures contained in it have come out. Sometimes a membrane or a thin skin may be found on these structures. If these structures are absent or ruptured, the cerebrospinal fluid (CSF) in the spinal canal leaks out. Almost all of these patients have serious problems such as inability to walk, inability to hold urine and feces, abnormalities in the spine and leg and foot bones due to damage to the neural structures.

5- How is spina bifida diagnosed?

With ultrasonography, which is widely used in pregnancy monitoring today, this abnormality is 16-20 of pregnancy. it can be deciphered between weeks. An important factor in the diagnosis is the determination of the alpha-feto protein level. Part of this protein, produced by the baby and secreted into the intrauterine fluid (amniotic fluid) decays into the mother’s blood by crossing the placenta, which provides the relationship between mother and child. The fact that this marker is high in the maternal blood is important in identifying the abnormality. Alpha-feto protein is also high in intrauterine fluid. If an abnormality is detected on ultrasonography and the alpha-feto protein value is high in the maternal blood, the diagnosis is finalized by taking a sample from here to determine the ratio inside the intrauterine fluid (amniocentesis).

6- What should be done in the treatment of spina bifida?

Meningocele and meningomyelocele should be surgically closed within the first days after the birth of the baby. Since the cerebrospinal fluid flows outwards in babies with meningomyelocele, an infection that may occur here can lead to inflammation of the brain membrane (meningitis). It should be known that the treatment of spina bifida in Turkey will be long-term and lifelong rehabilitation will be required. Treatment is a team effort. This team should include brain and nerve disease surgery, pediatric surgery/urology, pediatric neurology, pediatric nephrology, (pediatric) orthopedics, child psychiatry, physical therapy and physiotherapy, as well as a trained nurse in this field.

Wishing you a healthy day.

Prof. Dr.
Pediatric Surgery Specialist Istanbul Florya MedicalPark Hospital

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President of Organ Transplant Center at MedicalPark Hospital Antalya

Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.

Physician's Resume:

Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.

Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.

In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.

Awards:

Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.

Certificates:

Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .

Professional Members:

American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.

Disclaimer:

Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.
Medically Reviewed by Professor Doctor Alper Demirbaş
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