Prenatal covering of the spinal cord decreases neurologic sequelae in a myelomeningocele model.
OBJECTIVE
Recent experience in fetal surgery to correct myelomeningocele in humans reports an early reversion of hydrocephalus and decreased need of ventricular shunting in the first months of life; however, it has not been possible to demonstrate benefit in lower extremity function. In the present work, we have tried to ascertain the impact of cord exposure on hind limb function.


METHODS
Fetal rabbits with myelomeningocele (group M), treated myelomeningocele (group T), and control animals (group C) were compared at birth regarding physical examination, somatosensory-evoked potentials of the hind limbs, ventricular morphometry, and spine histology.


RESULTS
No major difference was found between groups M and T in the physical examination. Somatosensory-evoked potentials of the hind limbs were absent in group M and present in group T, although showing a longer latency period and decreased amplitude than controls. The area of the third ventricle was significantly larger in group M than in group C; in group T, it was also somewhat larger but not significantly so. Cord histology had evident changes in group M and minor changes in group T, which resembled normal group C cord.


CONCLUSIONS
Prenatal covering of the spinal cord prevents central and peripheral neurologic deterioration in this animal model of myelomeningocele.
Juliá
Victoria
V
Department of Pediatric Surgery, Unitat Integrada Hospital Clínic-Hospital Sant Joan de Déu, 08950 Barcelona, Spain. vjulia@hsjdbcn.org
Sancho
María A
MA
Albert
Asteria
A
Conill
Juan
J
Martínez
Antoni
A
Grande
Carme
C
Morales
Luís
L
D000818:Animals; D000831:Animals, Newborn; D002552:Cerebral Ventricles / Q000473:pathology; D004622:Embryo, Mammalian / Q000601:surgery; D005073:Evoked Potentials, Somatosensory; D005315:Fetal Diseases / Q000601:surgery*; D006614:Hindlimb / Q000503:physiopathology; D008591:Meningomyelocele / Q000196:embryology* / Q000473:pathology / Q000601:surgery*; D009422:Nervous System Diseases / Q000517:prevention & control*; D010296:Parietal Lobe / Q000503:physiopathology; D011184:Postoperative Period; D011817:Rabbits; D011930:Reaction Time; D013116:Spinal Cord / Q000196:embryology* / Q000473:pathology; D013524:Surgical Flaps