CHAPTER I
INTRODUCTION
The Spina bifida is a congenital defect of the posterior arch of the spine due to failure of closure of the neural elements of the spinal canal in the early development of embryos. (1,2,3)
In the early stages of neural plate formation of a gap is formed which then form the neural neural tube. Pipe is then a neural network of the brain and spinal cord. While in the womb, the tissue that forms neural tube does not close or not closed properly. This led to the opening in the vertebrae, which surrounds and protects the spinal cord. The process of neural tube closure takes place during the fourth week of embryonic life, and usually before a woman knows her pregnancy and ended. Neuralisasi process began at the dorsal midline and continues to sefal and caudal direction. The most recent closure occurred at the posterior end of the day-to-28. (3.4)
Sometimes it does not close the neural groove, this is because the error induced by chorda spinalis which lies beneath or under the influence of environmental teratogenic factors neuroepitel cells. Neural networks in this case remains open to the outside world. Disruption of this process causes neural tube defects which are then classified as disrafisme. Disrafisme divided into two cranial and spinal. (3,4)
Disrafisme spinal / myelodysplasia is a congenital anomaly of the spinal fusion caused by the failure of the structures at the midline. When the lesions confined to the bones (arch) whether one or more posterior levels, the disorder is referred to as spina bifida. (4, 5, 6)
If the neural elements involved it will cause paralysis and loss of sensation and sphincter disorders. The degree and localization of defects that occur vary. Light on the circumstances which may be found only a failure of fusion of one or more of the posterior arch of the vertebra at the lumbosacral region. Sometimes this disorder does not cause significant clinical symptoms. (1, 2,4,7)
Often the event of a defect in the posterior arch will give rise to disorders of the skin surface of the cover, which looks like a dimple, tuft of hair, skin or sinus fat mass.
Spina bifida can be classified into two types namely, spina bifida occult spina bifida and aperta (cystica). (1)
CHAPTER II
REVIEW REFERENCES
DEFINITION
Spina bifida is a developmental anomaly characterized by defective closure of the bones in the spinal cord sheath so that the lining of the spinal cord and meninges may protrude (spina bifida cystica), or does not protrude (spina bifida occulta) .(2)
Several hypotheses of spina bifida include: (4)
1. Cessation of neural tube formation process as a particular cause
2. Excess pressure in the central canal of the newly formed rupture surface, causing neural tube
3. The damage to the walls of the newly formed neural tube as a cause.
Protrusion of the spinal cord and meningens cause damage to the spinal cord and nerves, resulting in decreased or impaired function of the body parts supplied by these nerves, or at the bottom. Symptoms depend on the anatomical location of spina bifida. Most occur in the lower back, the lumbar or sacral region, due to the closure of the vertebrae in place at the end of this section.
Figure 1. Spina Bifida
