What is Spina Bifida?

During a fetus’ development in the womb, there is a group of cells called the neural tube that are responsible for forming the spinal cord and the brain.1 Typically, this should close during development and then be covered by the spine bone to protect the delicate spinal cord. Sometimes, however, it does not close all the way, causing the back bone to be incomplete.2

Children with spina bifida may experience other symptoms such as apnea, in which the child can forget to breathe, along with other respiratory problems, incontinence in the bladder and bowels, paralysis in the lower extremities, developed curves in the spine, and talipes (or clubfoot) which results in malformed or underdeveloped feet.3 Another common side effect, and sometimes what alerts parents to the problem, is hair growth or a dimple (sacral dimple) around the site of the spinal cord opening. This site is called the occulta, meaning “hidden” as the skin covers the spinal opening.4

There are three main types of spina bifida:

  • Spina bifida occulta (SBO): This is both the most common and most mild form of spina bifida. Also known as “hidden spina bifida,” many people will not even be aware that they have it until they have an X-ray for other reasons because it often does not have symptoms.
  • Meningocele: A sac of spinal fluid pushes through an opening in the back. This can have little to no symptoms, or create problems with continence in the bladder and bowels.
  • Myelomeningocele: This is the most severe form of spina bifida, as there may be multiple locations in the spine that have openings with sacs of spinal fluid poking out. Unlike meningocele, these sacs of spinal fluid also contain part of the spinal cord and nerves, which are usually damaged.

Stem cell therapy for spina bifida

Stem cells are regenerative in nature, able to differentiate into different types of cells the body needs to use, allowing the body to heal in ways it couldn’t on its own. By injecting stem cells into the injured site of a spina bifida patient, the stem cells can help to heal the opening of the spinal cord. In particular, while the prenatal surgery has been a great way to improve brain development, patients have still struggled with physical movement and incontinence. Stem cells have shown an ability to increase the physical capabilities of spina bifida patients, including muscle strength, incontinence, feeling and sensation, and general motor function.5

Another study published in August of 2018 has shown that stem cell therapy for spina bifida has been successful in two patients, aged 14 and 11. Though the study was small, it was promising in that both patients were unable to defecate or urinate on their own until after their stem cell treatments. After treatment, both patients were able to control their bowel movements as well as their urine. A larger study will be done in the future to confirm the efficacy of this treatment, however, this has been a promising breakthrough for spina bifida patients.6

What Makes our Treatment for Spina Bifida Effective?

At Beike, we have created a comprehensive therapy program to best suit patients with spina bifida. Our treatment consists of Umbilical Cord Derived Mesenchymal Stem Cells (UCMSCs) and Umbilical Cord Blood Stem Cells (UCBSCs), with simultaneous physical therapies to help guide the stem cells to the needed area. Umbilical cord-derived stem cells are actually more than just mesenchymal stem cells (MSC), and also include hematopoietic stem cells (HSC), endothelial progenitor cells (EPC), and others. These adult stem cells are able to differentiate into different types of cells, such as osteocytes (bone), chondrocytes (cartilage), myocytes (muscle), fibroblasts (tendon/ligament), adipocytes (fat), hepatic stellate cells (liver), endothelial cells (blood vessels), all blood cells, connective tissues and more. Studies also show that they can create neurons and glial cells.7 8 9 10

Potential improvements after the treatment

The purpose of the treatment is to promote healing of the original spinal cord/brain injury in order to restore neurological function. Thus, various kinds of improvement are possible after our treatment and our past patients have experienced the following*:

  • Improved motor function
  • Increased sensations
  • Improved development
  • Improved mental abilities
  • Increased muscle strength
  • Reduced epilepsy seizures
  • Enhanced bladder & bowel function

Our patients have seen excellent results after spina bifida stem cell therapy. Below are graphs of our patients’ improvements in both satisfaction and their quality of life:

More about Spina Bifida


Diagnosis

90% of spina bifida cases are discovered during an ultrasound before 18 weeks of pregnancy. Diagnosis is commonly done through a blood screening to test for alpha-fetoprotein (AFP) in the mother’s blood. Babies create this AFP protein that commonly reaches the mother’s bloodstream, but if the level of AFP is too high it could be a sign of spina bifida.

To determine the reason for high levels of AFP, a doctor will have an ultrasound done to confirm the reason. If further testing is needed, a doctor can perform an amniocentesis test in which a part of the amniotic fluid surrounding the baby is tested. If that fluid has a high concentration of AFP as well, it could be because the skin that should cover the spinal cord is not there and is causing a leakage of the baby’s spinal fluid.11

MRI and CT scans are also possible tools for post-natal diagnosis.1213

Conventional Treatment

When a mother learns that her baby has spina bifida, an in depth diagnosis is conducted to determine exactly how severe the spina bifida is for the child, and what treatment options are available or necessary. After a complete diagnosis, the mother can choose if she wants to terminate the pregnancy or proceed with or without treatment. A common method of treatment is to have prenatal surgery. During this surgery, the neurosurgeon will remove the abnormal sac of skin from the nerve tissue, then moves the exposed nerve tissue back into the spinal canal.14 However, if for whatever reason the mother does not choose to have fetal surgery, babies born with spina bifida can still have postnatal surgery. The surgery is almost exactly the same and with the same goal, just done later for what could be a combination of medical and personal reasons. Mothers will typically have a cesarean section birth so as not to risk further damage to the child and keep the myelomeningocele intact, and surgery will be done within the first two days of the child’s life.15

If the child suffers from hydrocephalus, which is common among myelomeningocele patients, doctors will often insert a shunt tube, which will drain fluid from the brain into the abdomen, which can then absorb the fluid. This can help with the symptoms of hydrocephalus, but can have its own complications and will often need to be replaced multiple times throughout a patient’s life.