Neural tube defects

Abstract

Neural Tube Defects (NTD) or Spina Bifida are disorders of neural tube development and closure and include a wide variety of abnormalities ranging from spina bifida occulta to anencephaly. Although the incidence of neural tube defects is less common today (0.5-1/1000 live births in some reports) and is falling, NTDs remain the most common congenital central neural system developmental disorder. The factors contributing to this decreasing incidence are in some part geographic and related to antenatal screening and termination of pregnancy but also relate to improved nutrition and folic acid supplementation. Improved standards of living and a falling birth rate have also impacted on a declining incidence. Despite this Spina Bifida is a cause of major morbidity with significant implications to the quality of life of the child but which also impacts significantly on the wellbeing of the family unit as a whole. Not surprisingly the management of these children involves a multi-disciplinary team approach with significant input from specialist paediatric surgeons, neurosurgeons, urologists, orthopaedic surgeons, paediatricians (especially rehabilitation) social workers, nursing, physiotherapy and child psychology.