From the Research
Screening for spina bifida in adults typically involves magnetic resonance imaging (MRI) of the spine, which is the most comprehensive diagnostic tool to detect this condition. Unlike prenatal screening, which uses maternal serum alpha-fetoprotein testing and ultrasound, adult screening focuses on identifying previously undiagnosed cases or evaluating complications in known cases. A complete neurological examination should also be performed to assess for symptoms like back pain, leg weakness, bowel or bladder dysfunction, and sensory changes. Plain X-rays may be used initially to identify bony abnormalities, but they cannot visualize the spinal cord itself. CT scans can provide detailed images of bone structure but are less effective for soft tissue evaluation. Urodynamic studies may be included to assess bladder function, as neurogenic bladder is a common complication, as seen in a study published in the Journal of Pediatric Rehabilitation Medicine in 2021 1. These screening methods are important because adults with undiagnosed spina bifida occulta or mild forms may develop progressive neurological symptoms due to tethered cord syndrome or syringomyelia as they age, requiring intervention to prevent further deterioration.
Key Considerations
- A thorough medical history and physical examination are essential in identifying adults with spina bifida who may require screening, as highlighted in a study published in Brain and Behavior in 2020 2.
- The presence of secondary conditions such as hydrocephalus, Chiari II malformation, tethered cord symptoms, and latex allergy should be considered, as noted in a study published in Brain and Behavior in 2020 2.
- Urodynamic studies can help identify bladder function issues, which are common in adults with spina bifida, as seen in a study published in the Journal of Pediatric Rehabilitation Medicine in 2021 1.
- Regular follow-up and monitoring are crucial to prevent and manage complications associated with spina bifida, as emphasized in a study published in the Journal of Pediatric Rehabilitation Medicine in 2009 3.
Screening Methods
- MRI of the spine: the most comprehensive diagnostic tool to detect spina bifida
- Complete neurological examination: to assess for symptoms like back pain, leg weakness, bowel or bladder dysfunction, and sensory changes
- Plain X-rays: to identify bony abnormalities
- CT scans: to provide detailed images of bone structure
- Urodynamic studies: to assess bladder function, as noted in a study published in the Journal of Pediatric Rehabilitation Medicine in 2021 1