1. What is spina bifida? One day, a mother came to the clinic with this 7-year-old boy. After detailed inquiry, we learned that the boy had occult spina bifida and was incontinent, and he had been transferred to many tertiary hospitals and consulted with neurology and neurosurgery. She was then referred by a friend to our clinic. I told her that spina bifida is a congenital condition in which the structure of the spine is abnormal during embryonic development due to various causes. Spina bifida is a common condition, the main cause of which is not known. It may be related to congenital genetics and the environment, and may be induced by folic acid deficiency during pregnancy, alcohol abuse, certain micronutrient deficiencies, viral infections, radiation, etc. It is a common condition with an incidence of between 8/10,000 and 10/10,000. Of these, the vast majority are occult spina bifida. The male to female ratio of spina bifida is (0.6~0.9):1. The incidence is higher in the north than in the south, and higher in rural than in urban areas. It is divided into dominant spina bifida and recessive spina bifida. Overt spina bifida is where a sac, sinus tract, hair, etc. can be seen in the back and is easily detected. Checking MRI can suggest spinal cord embolism, spinal membrane bulge, dermal sinus, and if not treated will result in urinary and fecal incontinence or difficulty, lower extremity developmental deformity, lower extremity muscle atrophy, foot entropion deformity, etc. Occult spina bifida is often difficult to detect abnormalities in the appearance, even if the MRI and CT, only suggest spina bifida, and the spinal cord is often not abnormal. 2.So how should spina bifida be treated? Spina bifida is not only characterized by back hair, protruding masses, and sinus tracts, but also by urinary and fecal disorders, lower limb deformities, spinal deformities, and in some cases, hydrocephalus, atlanto-occipital deformities, and subungual herniation of the cerebellar tonsils. If the spinal cord is embolized, the spinal cord should be carefully separated from the embolized spinal cord, and the thickened and mutated end filaments should be interrupted to loosen the spinal cord adhesions; even with systematic rehabilitation after surgery, most of the patients can return to normal life. Because it is difficult to detect the symptoms of occult spina bifida, the symptoms usually appear as constipation, urinary retention, urinary incontinence, loss of stool, scoliosis deformity, etc. In fact, another characteristic is that it affects the intellectual development, and some children may develop mental retardation, hyperactivity, etc. In addition, because such children have difficulty with urination and defecation, they can have psychological problems at school such as low self-esteem and anxiety, which can affect the affected child’s doctor if left untreated. Some doctors do not have a complete understanding of occult spina bifida because it is simply a case of the bones of the spine not closing and does not require treatment, which is actually completely wrong. The spinal column does not close completely and this inevitably affects the development of the spinal cord and brain, which is called “kidney qi deficiency” from a Chinese medicine perspective. Once found or symptoms appear, must be from the combination of Chinese and Western medicine and neurological rehabilitation to treat, most can be cured. 3. Can spina bifida be detected early? Some children with spina bifida can be detected by ultrasound during the mother’s pregnancy, but recessive spina bifida is extremely difficult to detect, even after birth, if clinical symptoms do not appear. Some children with poor academic performance may want to go to the hospital to check the whole brain and whole spinal cord MRI to rule out abnormal brain and spinal cord development, early detection and early treatment is much better than late detection before treatment. 4.Can spina bifida be cured? Most cases of spina bifida can return to normal life and normal bowel function through surgery and neurological rehabilitation. Many doctors only focus on how to operate, but do not care much about how to rehabilitate or treat after surgery, which often leads to many children missing the best rehabilitation time and leaving permanent bowel and urinary disorders. In fact, most of these children can be cured by starting a systematic combination of Chinese and Western medicine plus neurological rehabilitation and neuromodulation treatment as early as possible after surgery. Occult spina bifida is less symptomatic than overt spina bifida, and there is hope that early treatment can cure the disease once fecal loss and urinary leakage are detected. E530B2B37F4DDCFAD93EE2F154243F84.jpg 5. What happened to the child who came to that outpatient clinic in the end? Any disease involving the nervous system is basically a chronic disease, if anyone says it can be cured in just a few days, it is basically a lie. This child was treated with a combination of Chinese and Western medicine and electromagnetic nerve stimulation for two months, and his bowel movements were basically normal again. Spina bifida is a small branch of spinal cord injury, although there can be no imaging manifestations of spinal cord injury, but through electromyography, you can basically check the existence of varying degrees of damage to the cauda equina nerve, children with combined spinal cord injury, nerve regeneration ability, adhere to electromagnetic stimulation, most of them can restore urinary and fecal function, so when seeking medical advice must ask more questions, listen more and consult more information, which Doctors are good at treating spinal cord injury diseases.