SPINA BIFIDA

SPINA BIFIDA is a congenital malformation occurring perhaps more frequently than any other except hare-lip, and arising like it from arrest of development. It may be regarded as a congenital hernia of the membranes of the spinal cord through a fissure in the wall of the bony canal. A tumour is thus formed, which is usually of a roundish shape varying in size from that of an egg to that of an adult head, lying in the middle line of the back, fluctuating, and adhering to the adjacent vertebrae either directly or by a pedicle. The usual termination of the disease is death. As the size of the tumour increases, fatal convulsions ensue; or the skin investing the tumour may ulcerate and the contents escape, in which case palsy or convulsion produces death. Occasional cases are, however, recorded in which patients with this affection have survived till middle life. Surgical treatment has, until quite recently, been unsatisfactory; but with improved modern methods successful results have in many cases been obtained. Moderate support by means of a hollow truss, or a well-padded concave shield, may tend to keep the disease stationary; and any interference beyond this is, in the great majority of cases, unadvisable. For other diseases connected with the spine, see MENINGITIS, MYELITIS, LOCOMOTOR ATAXIA, &c.