Talk:Spina bifida

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Former good article nominee Spina bifida was a Natural sciences good articles nominee, but did not meet the good article criteria at the time. There are suggestions below for improving the article. Once these issues have been addressed, the article can be renominated. Editors may also seek a reassessment of the decision if they believe there was a mistake.
January 1, 2012 Good article nominee Not listed
WikiProject Disability (Rated B-class)
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Removal of SB Cystica[edit]

I recently removed the spina bifida cystica subsection under the "Classification" header. Since SB cystica and SB myelomeningocele (described in a separate subsection) are essentially the same type of the condition, I found it confusing to have two separate subsections in the Classification section. The current edition of the page will hopefully provide more concise, less confusing information for readers. - Cholbein —Preceding undated comment added 19:11, 11 October 2011 (UTC).

Recent article cuts by IP editors[edit]

Over the last few days, this article has seen some heavy cuts by anon IP editors. Over 10% of the article has been edited out, with no discussion and no edit summaries. I don't know enough about the topic to be sure if the edits are solid or otherwise—can someone who is qualified please take a look and give an opinion?

The IPs in question:

It'd be great to have this sorted before the edits get too mixed in with the usual changes such that they end up being the standard version. Thanks, Dori ❦ (TalkContribsReview) ❦ 05:36, 15 June 2009 (UTC)

The copy edits look responsible. The anon editors are doing helpful work. Kingturtle (talk) 12:29, 15 June 2009 (UTC)
The copy edits, yes. The wholesale removal of paragraphs, not so much—or at least not to me. Here's the full before and after diff. The edits that especially concern me are this, this, this, this, this, this, this, this, this, and this (to varying degrees). In particular, this edit changed the name in the infobox.
[Note: the 121. address is in Australia; all the others geolocate to a single ISP in Hong Kong] — Dori ❦ (TalkContribsReview) ❦ 22:41, 19 June 2009 (UTC)

Irish Immigrants?[edit]

The comment on Irish immigrants seems odd to me. I have not read the sources, but I suspect they are location specific. Is it contrasting Irish immigrants to some other place with locals of that other place, or is it contrasting Irish immigrants to Irish residents? Those are two completely different things. —Preceding unsigned comment added by Victor Engel (talkcontribs) 16:21, 16 June 2009 (UTC)

I entirely agree. I would have edited this, but I'm unable to check the references at the moment. Marchino61 (talk) 03:13, 19 July 2015 (UTC)

SB in fiction[edit]

An anon IP, User:98.164.112.86, added the paragraph:

The August tenth issue of The New Yorker magazine 2009 featured a story "War Dances" by Sherman Alexie which has as narrator an unnamed character who suffered from the condition as a child. In the course of the story the character gives a personal definition of the illness as "'the obese, imperialistic water demon that nearly killed me when I was a baby.'"

The short story in question can be found here. I searched it and found no use of the word "bifida." The paragraph that the quote above came from reads in full:

Merriam-Webster’s dictionary defines “hydrocephalus” as “an abnormal increase in the amount of cerebrospinal fluid within the cranial cavity that is accompanied by expansion of the cerebral ventricles, enlargement of the skull and especially the forehead, and atrophy of the brain.” I define “hydrocephalus” as “the obese, imperialistic water demon that nearly killed me when I was a baby.”

Or in other words, the author was writing about hydrocephalus, not SB, so I've reverted the change. Dori ❦ (TalkContribsReview) ❦ 02:10, 24 August 2009 (UTC)

Tethered cord[edit]

Hi this section of unreferenced text causes me some concern: The myelomeningocele (or perhaps the scarring due to surgery) tethers the spinal cord. In some individuals this causes significant traction on the spinal cord and can lead to a worsening of the paralysis, scoliosis, back pain, or worsening bowel and/or bladder function.[citation needed] I understand how this may occurr however, I've never spoken to a neurosurgeon who has indicated this is significant! —Preceding unsigned comment added by 203.42.251.3 (talk) 03:38, 11 August 2010 (UTC)

I've added a cite. Roger (talk) 14:44, 11 August 2010 (UTC)
Nicely done! Kingturtle (talk) 14:45, 11 August 2010 (UTC)

Notable people[edit]

Some of the people listed appear to be of doubtful notability, they don't seem to qualify in terms of the notabiliy guideline. I'm inclined to delete entries that do not have either a wikilinked biographical article here on WP or a reliable citation. Roger (talk) 14:13, 15 October 2010 (UTC)

the only notable people listed should be those who have Wikipedia articles. Kingturtle = (talk) 15:50, 16 October 2010 (UTC)
I am now removing all redlinked listings that don't have proper cites. They have been tagged as uncited for almost a year! Roger (talk) 06:52, 16 August 2011 (UTC)

Could stem cells be used to treat spina bifida?[edit]

I've read somewhere that stem cells could be used to cure the nerve damage, but I have no idea of how advanced it is or even if it's a real chance. Anybody knows about it? I think it's an important information that should be included in the article, if it's true. 82.158.252.62 (talk) 20:26, 3 July 2011 (UTC)

Vandalism[edit]

"If the opening is large enough, thFGDG is allows aHGF JHJportion ofJ FJd." This is either vandalism or a real cock-up, unfortunately I don't know enough about this subject to know how this sentence should end.

I get the feeling this can just be reverted, but I don't know how that's done. Perhaps someone more knowledgeable can chip in. 86.131.53.38 (talk) 15:42, 17 October 2011 (UTC)

Yes check.svg Done Roger (talk) 22:00, 17 October 2011 (UTC)

Cats?[edit]

Where is the stuff about Spina bifida on cats? --Zachc108 (talk) 09:29, 6 November 2011 (UTC)

There is no mention of cats in the article. However, cats are mammals just like humans and embryo development of all mammals is essentially identical in the early stages when NTDs occur, so logically one could expect to find cats (and other mamals) with SB, though I imagine very few survive to maturity. If you have any reliable material about SB in cats, or any other mammals, maybe you could add a small section about it. Just be careful of giving it undue weight as this article is actually about SB in humans. Roger (talk) 15:18, 6 November 2011 (UTC)

Article Review[edit]

This article is quite trustworthy, unbiased, quite complete, very well-written,and very accurate. I would suggest adding in something about comorbid psychological diagnoses — Preceding unsigned comment added by Rsilton (talkcontribs) 03:15, 23 December 2011 (UTC)

Add Rebecca Silton (talk) 03:19, 23 December 2011 (UTC)rsilton

GA Review[edit]

This review is transcluded from Talk:Spina bifida/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Jmh649 (talk · contribs) 01:41, 25 December 2011 (UTC)

Still needs a fair bit of work[edit]

  • Many of the references are old such as #4 and #19 (1988 and 1993). Refs should ideally be from the last 3-5 years may be 10 at most and there are lots of review articles that are available and are.
  • This article uses a fair number of primary sources. The content needs to be supported by secondary sources per WP:MEDRS such as review articles. Many of this exist for this condition. Sandler, AD (2010 Aug). "Children with spina bifida: key clinical issues.". Pediatric clinics of North America. 57 (4): 879–92. PMID 20883878.  Check date values in: |date= (help)
  • There are a number of style issues. Would be advisable to read the WP:MOS and make sure this article is compliant.

Will provide a more in depth review once these issues are addressed.--Doc James (talk · contribs · email) 01:41, 25 December 2011 (UTC)

I happen to be passing by and looking for a project for the next couple of days - I can't help with the references but I could certainly help with the style - could you give me a couple of pointers to things that you think should be particularly looked out for? Failedwizard (talk) 17:11, 26 December 2011 (UTC)
I think the references issues need to be dealt with before style can be addressed. I have closed the GAN as the editor in question is not very active.Doc James (talk · contribs · email) 20:58, 1 January 2012 (UTC)
  • Which parent should take what amount of folic acid before fathering or conceiving a child or children? It isn't at all clear from the introduction. Probably there are no studies on paternal age or health, but these would after all seem relevant to prospective parents. — Preceding unsigned comment added by 86.42.68.220 (talk) 03:37, 7 August 2012 (UTC)

"Notable people" versus "Notable cases"[edit]

In order to avoid an edit war the dispute about the section heading needs to be discussed. I am coming to this article from a disability rights point of view. (I'm one of the founders of WP:WikiProject Disability). I also happen to have SB myself. I find the use of the term "cases" to be very offensive. It also completely flies in the face of the generally accepted Social model of disability.

The people listed in the section are notable not merely because they happen to have SB, they are notable due to their professional, sporting or other achievements. Therefor it is incorrect to refer to them as merely "cases" as if they are laboratory specimens in pickle jars. Roger (talk) 19:07, 28 January 2012 (UTC)

They are notable cases not just notable people. But would be happy to hear what others have to say.--Doc James (talk · contribs · email) 19:56, 28 January 2012 (UTC)
Being a person trumps being a case. Doc James, your post is a perfect example of why the Medical model of disability is evil. The people listed are WP:Notable (in the Wikipedia sense of the word) not merely because they happen to have SB, they are notable neurosurgeons, musicians, athletes, politicians, etc. Most of them achieved notability in spite of having SB, they are not notable for being "cases". I repeat - they are not specimens in jars. Roger (talk) 20:09, 28 January 2012 (UTC)


Hello everyone,

I've had a look at the reverts, and I think I can see both points of view. I can certainly imagine that in a medical article like this one it would be usual to talk of 'cases', and I can equally see that term winding up some other users.

To give my perspective, I think that there's an ambiguity in the english used here anyway. I personally would expect 'Notable Cases' of SB to be highly unusual manifestations of the condition. So for example, the very first case would be a notable case, or the first time an operation was performed successfully, would be "notable cases" for me. The list as it stands, does look like it's a list of people in the public eye who happen to have the condition, so I would expect it to be referred to as notable people (they must be notable people anyway if they have wiki-articles, but that's a different thread to this argument). But I'd like to start a dialog on this.

(for full disclosure I've arrived at this article from the note at Wikipedia_talk:WikiProject_Disability#Edit_dispute_at_Spina_bifida - but the area of Disability I specialise in is a long way from this)Failedwizard (talk) 21:47, 28 January 2012 (UTC)

I agree with Failedwizard here, that "notable case" presumably concentrates on an aspect of the condition or its treatment. It is not automatically an incorrect term to use (or at least should not be regarded as such), but for this usage "notable examples" may be a better choice. I imagine it would also be improper to regard the person concerned as "notable" merely because they have SB. Thus we may create a WP article about a notable crime, but do not create an article about the victim of that crime if that is the only reason why they have come to public notice. If we have one section title covering a combination of cases or examples and notable people, then we should probably accept that "cases" would not be right, and perhaps "people" should be used if the section mentions notable people ("trumping" as Roger has said). --Mirokado (talk) 22:16, 28 January 2012 (UTC)

Ultrasound image of fetal spine[edit]

The image is of an apparently normal spine - no sign of SB is evident. Is this image really useful and relevant in this article? Roger (talk) 13:40, 27 February 2012 (UTC)

This image is at present the best evidence of absence of SB in prenatal screening (Besides the banana and lemon singns as indirect markers)--Moroderen (talk) 22:07, 27 February 2012 (UTC)
I think you may be missing my point. In an article about for example Apples we do not include photos of Pears to illustrate "this is what 'not an apple' looks like". I think an ultrasound image that does show an SB lesion would be better. I might be able to obtain such an image and probably also a photo of a lesion taken shortly after birth. Roger (talk) 07:32, 28 February 2012 (UTC)
I do not agree, because apples are not a variant of pears while desease is a variant of normality with bad consequences. In screening, recognising a normal spine has two effects: for the doctor it is a way to understand how an abnormal spine looks like (a model), for the pregnant woman a way to be assured. I will anyhow provide a gallery of pictures of the lemon and banana signs and a video of a mielomeningocele in the fetus. Regards --Moroderen (talk) 12:21, 28 February 2012 (UTC)

Conflicting statistics[edit]

The article contains conflicting information about how common spina bifida is. In the section "Classification : Spina Bifida Occulta", it is stated that %10 of the population has this form of spina bifida. I do not believe this to be true. The reference for that information ([4] Saluja PG (1988). "The incidence of spina bifida occulta in a historic and a modern London population". J Anat. 158: 91–93. PMC 1261979. PMID 3066791.) is from a study of two London populations, and as such are not indicative of the world population, nor does the referenced research claim to provide an accurate percentage with regards to the London population as a whole. In the section "Classification : Myelomeningocele", myelomeningocele is purported to be the most common type of spina bifida. The research article referenced ([11] "Myelomeningocele". NIH. Retrieved 2008-06-06.) states that 1 per 800 births has this defect. This is far less than the %10 that the wikipedia article currently claims have spina bifida occulta. Could someone double-check me on that, and make appropriate changes (I'm not sure how to resolve this. Removing a misused, but referenced 'fact' seems extreme, but that's what I'd be inclined to do.) Golond (talk) 04:47, 3 July 2012 (UTC)

Firstly Myelomeningocele is not Occulta - in fact they are the opposite extremes of the Spina Bifida spectrum. Occulta is not normally counted as a birth defect - it is almost never diagnosed neonatally. When it is diagnosed at all, it is mostly discovered incidentally later in life. I hope this helps to reolve the apparent conflict. Roger (talk) 07:20, 3 July 2012 (UTC)

Mellencamp[edit]

The article SOURCE for Mellencamp is a broken link, so there is no article sourcing that Mellencamp actually has S.B. Stopde (talk) 13:30, 4 December 2012 (UTC)

I replaced it. Actually the list doesn't really need cites because the linked articles contain the necessary information anyway. Roger (talk) 12:36, 6 December 2012 (UTC)

Lymphedema/Lymphedeoma & SPina Bifida[edit]

I feel it would be helpful to people researching Spina Bifida if a section on associated conditions that can occur be included on the page. e.g. Lymphedema/Lymphedeoma my son with Spina Bifida now has Lymphedema and had we known earlier we could have got a referral to a specialist much earlier and caught it earlier, as it transpired the medics & his parents just thought he was puttign on weight and no matter what diet regime we used, being unable to excercise (electric wheelchair user) the weight piled on. We now know he has Lymphedema of the legs & trunk and appropriate measures are being take, but it is closing the door after the vent rather than being informed ahead of the event, had we known of the possibility of Lymphedema occuring we would have been watching for signs much earlier.

Your Views please. — Preceding unsigned comment added by Dbridge276 (talkcontribs) 12:51, 3 January 2013 (UTC)

Rx warning.png We cannot offer medical advice. Please see the medical disclaimer, and contact an appropriate medical professional.
That's a rule on Wikipedia - we are not under any circumstances ever allowed give medical (or legal) advice. BTW Lymphedema is a risk for anyone with decreased mobility from any cause, it has no specific link to SB. If you contact me on my talk page I can refer you to a specialist forum about SB. Roger (talk) 13:03, 3 January 2013 (UTC)

Effect of folic acid[edit]

Under Prevention can we say how much the incidence of SB is reduced by folic acid/folate supplementation ? Causes of spina bifida (NHS choices) says it may reduce it by 'up to' 70%. - Rod57 (talk) 11:07, 24 March 2013 (UTC)

Epidemiology - environmental pollutants[edit]

What can we say about correlation of incidence with environmental pollutants ? eg Some claim higher incidence in war regions with use of depleted uranium. - Rod57 (talk) 10:56, 24 March 2013 (UTC) Yes, definitely environmental pollutants. In the parts of Mexico that are close to Texas, there are statistically significant cells of SB whose locations correlate well with locations of factories that produce hi-tech electronic components, and at the same time release into the environment vast amounts of the corresponding enormously toxic wastes, such as various fluorine-containing solvents. 110.146.211.159 (talk) 11:26, 27 October 2013 (UTC)

Epidemiology - associations/causes[edit]

Birth defects says "...increased risk of having a baby with spina bifida. These conditions include (2,3): Obesity, Poorly controlled diabetes, Treatment with certain anti-seizure medications" (2: American College of Obstetricians and Gynecologists (ACOG). Neural Tube Defects. ACOG Practice Bulletin, number 44, July 2003 (reaffirmed 2008). 3: Fichter, M.A., et al. Fetal Spina Bifida Repair – Current Trends and Prospects of Intrauterine Neurosurgery. Fetal Diagnosis and Therapy, 2008, volume 23, pages 271-286. )
Spina bifida, risk factors (Mayo clinic) mentions valproic acid (maybe due to antifolate activity) and elevated core temperature. - Rod57 (talk) 11:31, 24 March 2013 (UTC)

frequency[edit]

This ref does support the number for the us [1] The other ref says "Spina bifida occulta is a common spectrum condition, present in approximately 5% of the population" Does not say US specifically Extra details that data from 2000-2004 can go in the body to keep the lead simplier. Doc James (talk · contribs · email) 20:26, 20 July 2015 (UTC)

Fetal surgery[edit]

I have continued to remove the small primary sources from the main treatment section. There are secondary sources available and we should use them per WP:MEDRS. Doc James (talk · contribs · email) 23:46, 20 December 2015 (UTC)

Learning Problems[edit]

I noticed that the lede suggests that learning problems are uncommon, referencing NIH, which, in turn, references the March of Dimes, which seems to say just the opposite. In the body of the article, the statement: "In one study, 60% of children with spina bifida were diagnosed with a learning disability..." suggests that learning problems are NOT at all uncommon. Does anybody know which it is? Desoto10 (talk) 05:06, 18 February 2016 (UTC)

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US prevalence[edit]

The epidemiology section currently states "In the United States [spina bifida] affected about 0.7 per 1000 births" linking to this page. That article does not mention 0.7 per 1000 births, only that "About 1,500 infants are born with spina bifida each year in the United States", as of a study using data from 1999-2001. CDC also states 1,500 per year, citing this study from 2004-2006 (it's paywalled so I couldn't verify it correctly represents the article).

If 1,500 from 2006 is the latest data available, the rate should be compared against the total live births from that time. While the CDC's latest birth rate estimate is 3,988,076 as of 2014, the closest to 2006 is 4,138,349 from this page (via HHS) as of 2005.

So the latest US estimate should be 1,500 / 4,138,349 = 0.036%, or 0.36 per 1000 births, putting the US in line with the 0.4 estimate from other developed countries.

Is this the best data available, and if so should it be changed to reference the two separate figures (1,500 and 4.1M)?

Edit: actually this separate CDC page shows a rate of 17.99 per 100,000 (0.18 per 1,000) as of 2006, specifying 700 cases in that year. This conflicts with the CDC's other estimate of 1,500 per year as of a similar date. It's unclear which is more accurate. MaxGhenis (talk) 05:12, 26 September 2016 (UTC)

Yes looking at the underlying paper it givens a prevalence per 10,000 live births of 3.68. So that would be 0.4 per 1000. Updated. Doc James (talk · contribs · email) 05:27, 26 September 2016 (UTC)

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