What is Spina Bifida?
Spina Bifida (SB) is the most common of a group of birth defects called neural tube defects (NTDs). The condition results from the failure of fusion of the neural tube (the embryonic structure thatdevelops into the brain and spinal cord).
Sometimes referred to as open spine, SB affects the vertebrae(small bones of the spine) and sometimes the spinal cord. The most common location of the malformation is in the lumbar or sacral (lower back) areas of the spinal cord. It typically results in paralysis of the lower limbs, hydrocephalus, incontinence of bowel and bladder, lack of sensation below the lesion, and dislocated hips.
At birth SB tends to be more common in girls than boys however prevalence of SB varies across time, by region, and by both race and ethnicity. There is an average worldwide incidence of 1 case per 1000 births, but certain populations have a significantly greater risk.
There are three main forms of SB:
Occulta
This is the mildest form and is often symptom less however the degree of disability is dependent upon the location of the lesion. There is usually a small defect or gap in one or more of the vertebrae of the spine and the spinal cord and nerves remain unaffected.
Cystica or Myelomeningocele
This is most severe form. This involves the meninges (membranes surrounding the spinal cord), nerve roots and sometimes the spinal cord itself protruding through a cleft to form a clearly visible sac or cyst. The cleft is surgically closed shortly after birth.
Meningocele
In this least common form the outer part of the vertebrae are split and the meninges and cerebrospinal fluid are pushed out through the opening. The nerves are not usually damaged therefore there is often little disability.
Bambach understands the problems associated with Spina Bifida
- Lower limb weakness or paralysis and sensory loss
- Bowel and bladder dysfunction
- Orthopaedic abnormalities such as kyphosis, scoliosis, clubfoot, muscle contractures, hip dislocation
- Hydrocephalus (accumulation of fluid on the brain)
- Chari II malformations
- Growth retardation
The Bambach design, Spina Bifida and Riding for the Disabled
The Bambach saddle seat was designed by an Australian Occupational Therapist as a result of her observation following years spent working with 'Riding for the Disabled'.
She found that disabled individuals suffering from neurological conditions such as SB often had great difficulty in maintaining a healthy posture and assumed a 'collapsed' or 'slouched' posture when seated in a conventional wheelchair and required considerable support (or strapping) to remain sitting.
These same individuals when sat on horseback were however capable of sitting independently and unsupported and showed remarkably improved functional abilities as a result of being put on a horse on a saddle.
