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J Pediatr Rehabil Med 2018 ;11(4):243-254

Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.

Purpose: To describe pulmonary function and determine the impact of neurological level, scoliosis, and obesity on pulmonary function in people with spina bifida (SB).

Methods: Participants with SB (N= 29) (15 females; age, 30 ± 12 years) completed spirometry and body plethysmographic lung volume testing. Univariate and multivariate regression analyses were used to describe the factors associated with pulmonary function in people with SB. Read More

World Neurosurg 2019 Feb 5. Epub 2019 Feb 5.

Pediatric Neurosurgery Department, Hospital Virgen del Rocio, Avda. M Siurot n/n, Advanced Neurology Center, Avda M Siurot 43, 41013 Seville. Electronic address:

The release of the placode and reconstruction of the myelomeningocele preserving the maximum of neural tissue is a challenge for the neurosurgeons. Vascular fluorescence with indocyanine green and / or fluorescein allows to observe the microvascularization of the spinal cord and adequately identify viable tissue. Read More

Birth Defects Res 2019 Feb 1. Epub 2019 Feb 1.

Department of Pediatrics, Selçuk University, Selçuklu Medical Faculty, Konya, Turkey.

Background: Additional congenital anomalies have often been found in patients with neural tube defect (NTD). We aimed to find out the clinical features, short term prognosis, treatment approaches, and systemic anomalies of NTD patients in the Konya region.

Method: A total of 186 newborn babies with NTD were retrospectively included in the study and all were assessed in detail for congenital anomalies and clinical features. Read More

No Shinkei Geka 2019 Jan;47(1):27-37

Department of Neurosurgery, Center for Neurological Diseases, Niigata Medical Center.

J Surg Res 2019 Mar 31;235:227-236. Epub 2018 Oct 31.

Department of Bioengineering, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado; Division of Pediatric Surgery, Department of Surgery, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado. Electronic address:

Background: Myelomeningocele (MMC) results in lifelong neurologic and functional deficits. Currently, prenatal repair of MMC closes the defect, resulting in a 50% reduction in postnatal ventriculoperitoneal shunting. However, this invasive fetal surgery is associated with significant morbidities to mother and baby. Read More

J Indian Assoc Pediatr Surg 2019 Jan-Mar;24(1):21-26

Department of Paediatric Surgery, Christian Medical College, Vellore, Tamil Nadu, India.

Context: It is often a challenge to counsel parents with children operated for spina bifida aperta in developing countries. Data regarding the efficacy of simple measures and preventive are scarce.

Aims: The aim of this study is to study such children for the incidence, prevalence of bowel bladder dysfunction, and the quality of life (QOL) in children who are involved with a multidisciplinary team in India. Read More

J Craniofac Surg 2019 Jan 19. Epub 2019 Jan 19.

Division of Plastic Surgery.

Myelomeningocele (MMC) is a type of open neural tube defect characterized by exposure of the spinal cord through a defect in the skin and posterior hindbrain herniation through the foramen magnum. Outcomes vary but common morbidities include paraplegia, hydrocephalus, neurogenic bladder, scoliosis, and tethered cord. Fetal surgery, although not a cure, has been shown to decrease the risk of associated morbidity. Read More

Ultrasound Obstet Gynecol 2019 Jan 23. Epub 2019 Jan 23.

Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, United States.

Background: Fetoscopic myelomeningocele (MMC) repair has unknown effects on fetal growth. Fetal surgery itself and/or exposure to a CO environment during spina bifida repair may affect placental function and impair fetal growth.

Objective: To assess growth in fetuses and infants with MMC who underwent a prenatal fetoscopic or open repair. Read More

Plast Reconstr Surg Glob Open 2018 Dec 14;6(12):e2012. Epub 2018 Dec 14.

Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Mie University, Tsu, Japan.

Major wound necrosis is an uncommon yet critical complication of meningomyelocele surgical repair with few reports available. Management is demanding and often requires further reconstructive surgery. We report a case of a neonate who developed extensive wound necrosis with dehiscence following primary repair of myelomeningocele. Read More

Neurospine 2018 Sep 4. Epub 2018 Sep 4.

Department of Neurosurgery, Kovai Medical Center and Hospital, Coimbatore, India.

Epidermoid cysts of the spine are rare tumors. While majority of them occur spontaneously, very few occur following a previous surgery for spinal dysraphism. Such tumors tend to occur at the site of previous surgery. Read More

Br J Neurosurg 2019 Jan 17:1-3. Epub 2019 Jan 17.

a Department of Plastic Reconstructive and Aesthetic Surgery , Cumhuriyet University Faculty of Medicine , Sivas , Turkey.

Background: Early closure of the meningocele, meningomyelocele, is essential to prevent complications such as hypothermia, infection in the postnatal period. But for some reasons, it is not always possible to repair early. The possibility of malign transformation should be considered in long-term due to nonhealing ulcers and cerebrospinal fluid (CSF) fistula and frequent infections in an adult patient with meningomyelocele. Read More

J Ayub Med Coll Abbottabad 2018 Oct-Dec;30(4):520-523

Department of Neurosurgery, Ayub Medical College, Abbottabad, Pakistan.

Background: Myelomeningocele is a congenital anomaly of Central Nervous System (CNS) leading to serious sequels related to various systems and organs of the affected patient. Hydrocephalus is a common condition associated with myelomeningocele. Hydrocephalus is seen in 11. Read More

Ultrasound Obstet Gynecol 2019 Jan 8. Epub 2019 Jan 8.

Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, United States.

Objectives: To determine if fetal brain imaging in fetuses that underwent prenatal repair of neural tube defect (NTD) can predict the need for postnatal hydrocephalus treatment (HT) in the first year postpartum.

Methods: This was a prospective study of fetuses diagnosed with open neural tube defect that had in-utero myelomeningocele repair between April 2014 and April 2016. Independent variables were collected from four chronological sets of fetal images: pre-surgery ultrasound, pre-surgery MRI, 6-week post-surgery MRI and pre-delivery ultrasound. Read More

J Matern Fetal Neonatal Med 2019 Feb 3:1-6. Epub 2019 Feb 3.

a Department of Obstetrics and Gynecology , Fetal Medicine Unit , Santiago , Chile.

Objective: To describe the use of a self-retaining thermoplastic polyurethane wound retractor for the management of hysterotomy during prenatal repair of myelomeningocele.

Methods: The preliminary experience with 16 consecutive cases of open surgery for prenatal repair of myelomeningocele using a new technique is presented. Under general anesthesia, the gravid uterus was partially exteriorized through a low transverse abdominal incision and a high 3-4-cm midline vertical mini-hysterotomy was performed. Read More

Anaesthesiol Intensive Ther 2018 ;50(5):385-386

Department of Anesthesiology and Intensive Therapy, Health Sciences University Medical School, Turkey.

Neurourol Urodyn 2018 Aug;37(S6):S61-S66

Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.

Aims: Videourodynamics is the addition of imaging to invasive urodynamics and one of the methods to ensure objective diagnosis in persons with signs or symptoms of lower urinary tract dysfunction. This manuscript has the aim to outline the basics of the practice of videourodynamics and to elementary explain interpretation of the results.

Methods: Literature sources and expert opinion were arranged to provide the reader with an introductory overview of current knowledge. Read More

Clin Imaging 2018 Nov 20;54:100-102. Epub 2018 Nov 20.

Department of Radiology and Imaging Sciences, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.

A classic metaphyseal lesion (CML) is highly specific for nonaccidental trauma. Missing CMLs can be devastating to the child as the child can continue to be exposed to inflicted trauma. Yet, there are rare case reports on CMLs that occur due to birth trauma, IV line placement, and treatment for clubfoot. Read More

Childs Nerv Syst 2019 Jan 4. Epub 2019 Jan 4.

Unit of Pediatric Neurosurgery, University Hospital La Fe, Valencia, Spain.

Background: Closure of the skin defect in myelomeningocele repair determines the quality of the surgical result. In large myelomeningoceles, the direct closure or by skin undermining may not be possible. In these cases, the skin defect must be closed using flaps to provide a tension-free and successful closure. Read More

Prenat Diagn 2019 Jan 4. Epub 2019 Jan 4.

Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine & Texas Children's Hospital, Houston, TX, USA.

Objectives: To describe and compare placental and amniotic histology in women who underwent a fetoscopic myelomeningocele repair to those who underwent an open hysterotomy myelomeningocele repair. Also, we intended to compare findings from both prenatal repair groups to age-matched control pregnant patients.

Methods: Placental and membrane histopathology from 43 prenatally repaired spina bifida cases (17 fetoscopic and 26 open) and 18 healthy controls were retrospectively assessed. Read More

J Child Orthop 2018 Dec;12(6):575-581

Department of Orthopaedics, UZ Leuven Campus Pellenberg, Pellenberg, Belgium.

Purpose: Although non-idiopathic clubfeet were long thought to be resistant to non-surgical treatment methods, more studies documenting results on treatment of these feet with the Ponseti method are being published. The goal of this systematic review is to summarize current evidence on treatment of non-idiopathic clubfeet using the Ponseti method.

Methods: PubMed and Limo were searched, reference lists of eligible studies were screened and studies that met the inclusion criteria were included. Read More

Surg Neurol Int 2018 26;9(Suppl 4):S73-S84. Epub 2018 Nov 26.

Department of Paediatric Surgery, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina.

Objective: The aim of this study is to describe the surgical technique, obstetrical evolution, and perinatal outcomes of a cohort of fetuses undergoing intrauterine surgery to repair open spina bifida (OSB).

Methods: We performed a prospective analysis of 21 consecutive fetuses with OSB at our institution between 2015 and 2017. The surgical technique was similar to that described in the management of myelomeningocele study (MOMS) (Funded by the National Institutes of Health; ClinicalTrials. Read More

Spine Deform 2019 01;7(1):107-111

Pediatric Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.

Objective: The objective of this study is to identify preoperative laboratory values and patient factors that are associated with postoperative respiratory complications in pediatric neuromuscular scoliosis (NMS) populations undergoing posterior spinal fusion (PSF) with instrumentation.

Summary Of Background Data: PSF in NMS patients are high-risk surgeries. Respiratory complications are the most common postoperative event, with rates up to 28. Read More

J Pediatr Surg 2018 Nov 5. Epub 2018 Nov 5.

Department of Paediatric Urology, Royal Belfast Hospital for Sick Children, Northern Ireland.

Purpose: We instituted early clean intermittent catheterization (CIC) in 1997 for all newborn infants with spina bifida (SB). We compared this group to a historical group managed expectantly to see if early catheterization was associated with a reduction in renal scar rate as determined by DMSA scanning.

Methods: Data were studied retrospectively on all infants with SB over a recent 13-year period who were treated with early universal CIC in a regional pediatric urology department. Read More

Pediatr Phys Ther 2019 01;31(1):75

UPMC Children's Hospital of Pittsburgh Pittsburgh, Pennsylvania.

Childs Nerv Syst 2018 Dec 11. Epub 2018 Dec 11.

School of Medicine, Department of Neonatology, Celal Bayar University, Manisa, Turkey.

Purpose: Kyphosis is the most severe spinal deformity associated with meningomyelocele (MMC) and is seen in approximately 15% of neonates. Our purpose is to present our clinical experience, to discuss the technique and deformity correction in kyphectomy in neonates with MMC, and to assess its long-term outcomes.

Method: In this prospective study, the authors reviewed eight cases submitted to surgery between 2013 and 2015. Read More

Prenat Diagn 2019 Jan 10;39(1):10-15. Epub 2018 Dec 10.

Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital and University of Toronto, Toronto, Canada.

Objective: Fetal myelomeningocele (fMMC) surgery improves infant outcomes when compared with postnatal surgery. Surgical selection criteria and the option of pregnancy termination, however, limit the number of cases that are eligible for prenatal surgery. We aimed to quantify what proportion of cases could ultimately benefit from fetal therapy. Read More

J Pediatr Surg 2019 Jan 4;54(1):75-79. Epub 2018 Oct 4.

Department of Surgery, University of California Davis, Sacramento, CA, USA.

Purpose: The purpose of this study was to determine whether seeding density of placental mesenchymal stromal cells (PMSCs) on extracellular matrix (ECM) during in utero repair of myelomeningocele (MMC) affects motor function and neuronal preservation in the ovine model.

Methods: MMC defects were surgically created in 33 fetuses and repaired following randomization into four treatment groups: ECM only (n = 10), PMSC-ECM (42 K cells/cm) (n = 8), PMSC-ECM (167 K cells/cm) (n = 7), or PMSC-ECM (250-300 K cells/cm) (n = 8). Motor function was evaluated using the Sheep Locomotor Rating Scale (SLR). Read More

J Matern Fetal Neonatal Med 2018 Dec 10:1-6. Epub 2018 Dec 10.

b Department of Obstetrics and Gynecology , Mayo Clinic , Rochester , MN , USA.

Objectives: To summarize current evidence on the use of tocolytic medications perioperatively for open prenatal repair of fetal myelomeningocele including tocolytic agent options, regimens, efficiency, and potential risks.

Methods: A search of Medline, Embase, and SCOPUS databases was conducted from inception to March 2017. Studies that described their tocolytic protocol, gestational age at delivery, perinatal outcomes were included. Read More

J Pediatr Surg 2018 Nov 5. Epub 2018 Nov 5.

Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA. Electronic address:

Purpose: Transamniotic stem cell therapy (TRASCET) with select mesenchymal stem cells (MSCs) has been shown to induce partial or complete skin coverage of spina bifida in rodents. Clinical translation of this emerging therapy hinges on its efficacy in larger animal models. We sought to study TRASCET in a model requiring intra-amniotic injections 60 times larger than those performed in the rat. Read More

Pediatr Phys Ther 2019 01;31(1):68-75

Department of Kinesiology (Dr Lee), California State University Fullerton, Fullerton, California; Doctoral Program in Physical Therapy (Dr Sansom), School of Rehabilitation and Medical Sciences, Central Michigan University, Mount Pleasant, Michigan.

Purpose: To determine the feasibility of an early treadmill training program for infants with myelomeningocele (MMC) and to measure changes in overt infant motor development and control, including mechanisms underlying the overt changes.

Methods: Ten infants with MMC were initially enrolled: 8 infants completed 12 consecutive months of training, and 2 completed 6 months of training. Training consisted primarily of home-based, parent-administered treadmill stepping practice 5 days per week, 10 minutes per day starting within 6 months postbirth. Read More

Eur J Anaesthesiol 2019 03;36(3):175-184

From the Anaesthesiology and Intensive Care Department (SM, IG, MP, RP, DB, MdN), Maternal-Fetal Medicine Department (NM, SA, EC), Paediatric Surgery Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (CG, JAM, ML).

Background: Prenatal myelomeningocele repair by open surgery can improve the neurological prognosis of children with this condition. A shift towards a fetoscopic approach seems to reduce maternal risks and improve obstetric outcomes.

Objective: The aim of this study was to report on the anaesthetic management of women undergoing prenatal open or fetoscopic surgery for neural tube defects. Read More

J Pediatr Rehabil Med 2018 ;11(4):255-264

Skåne University Hospital, Lund, Sweden.

Purpose: To increase knowledge about pain and general health in adults with myelomeningocele, a health condition with several risk factors for pain such as musculoskeletal deformities, shunt dysfunctions, bowel problems, and urinary tract infections/stones.

Methods: Descriptive correlational pilot study (N= 51, 53% males). Chi-square tests were used to test associations among presence, impact, severity, and pain site in relation to sex and age. Read More

J Pediatr Rehabil Med 2018 ;11(4):217-225

Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA.

Background: Prenatal surgery for myelomeningocele (MMC) has been demonstrated to have benefits over postnatal surgery. Nevertheless, prenatal surgery requires a significant emotional, physical, and financial commitment from the entire family.

Methods: Mixed methods study of parents' perceptions regarding provider communication, treatment choices, and the family impact of having a child with MMC. Read More

J Pediatr Rehabil Med 2018 ;11(4):227-235

The George Washington University Biostatistics Center, Rockville, MD, USA.

Purpose: To evaluate for differences in neurodevelopmental outcomes at 30 months of age for children enrolled in the Management of Myelomeningocele Study (MOMS) based on the presence of hydrocephalus and cerebral shunts.

Methods: Children with no hydrocephalus (N= 27), children with shunted hydrocephalus (N= 108), and children with unshunted hydrocephalus (N= 36) were compared at 30 months of age on the Bayley II Mental and Psychomotor Indices, the Peabody Developmental Motor Scales-2 and the Preschool Language Scale, 4th edition. Generalized linear models were used to adjust for factors significantly different between the groups at baseline. Read More

World J Nucl Med 2018 Oct-Dec;17(4):249-252

Hospital de Base do Distrito Federal - Nuclear Medicine Service, Brasília, Brasil.

The aim of this study was to assess the colonic transit in children and teenagers with chronic constipation. Twenty patients from 1.5 to 16 years old were included (mean age = 6. Read More

Int J Obstet Anesth 2019 Feb 23;37:135-136. Epub 2018 Oct 23.

Servicio de Obstetricia, Hospital Italiano de Buenos Aires, Argentina.

J Neurosurg Pediatr 2018 Oct 1:1-6. Epub 2018 Oct 1.

1Department of Neurosurgery, Emory University School of Medicine, Atlanta; and.

OBJECTIVEThe majority of children with myelomeningocele undergo implantation of CSF shunts. The efficacy of adding surveillance imaging to clinical evaluation during routine follow-up as a means to minimize the hazard associated with future shunt failure has not been thoroughly studied.METHODSA total of 300 spina bifida clinic visits during the calendar years between 2012 and 2016 were selected for this study (defined as the index clinic visit). Read More

J Neurosurg Pediatr 2018 Oct 1:1-10. Epub 2018 Oct 1.

1Surgical Outcomes Center for Kids, Monroe Carell Jr. Children's Hospital at Vanderbilt.

OBJECTIVEMany studies have aimed to determine the most clinically effective surgical intervention for hydrocephalus. However, the costs associated with each treatment option are poorly understood. In this study, the authors conducted a cost-effectiveness analysis, calculating the incremental cost-effectiveness ratio (ICER) of ventriculoperitoneal shunting (VPS), endoscopic third ventriculostomy (ETV), and ETV with choroid plexus cauterization (ETV/CPC) in an effort to better understand the clinical effectiveness and costs associated with treating hydrocephalus. Read More

J Paediatr Child Health 2018 Nov 28. Epub 2018 Nov 28.

Department of Pediatric Nephrology, Medical University of Białystok, Białystok, Poland.

Aim: We wanted to investigate serum levels of ghrelin and leptin - appetite-regulating hormones - and their correlation with the nutritional status of children with neurogenic bladder (NB) due to myelomeningocele (MMC) in comparison to healthy individuals.

Methods: This prospective analysis was conducted on 67 children with NB after MMC and 20 healthy children. Children's medical charts were analysed to determine age, gender, anthropometric measurements, body mass index (BMI), activity assessment using Hoffer's scale and renal function parameters. Read More

Pediatr Neurosurg 2018 Nov 27:1-5. Epub 2018 Nov 27.

Department of Neurosurgery, Hannover Medical School, Hannover, Germany.

We introduce a novel technique for the treatment of severe kyphosis in myelomeningocele. A 5-year-old paraplegic boy with myelomeningocele presented with severe thoracolumbar kyphosis and a chronic ulcus at the site of the gibbus. The myelomeningocele had been treated during his first week of life, and an accompanying Chiari type II malformation had been treated by ventriculoperitoneal shunting. Read More

World Neurosurg 2018 12;120:590

Department of Radiology, Mayo Clinic, Rochester, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, USA.

Ultrasound Obstet Gynecol 2018 Nov 21. Epub 2018 Nov 21.

The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Victoria, Australia.

Objectives: Partial amniotic carbon dioxide (CO ) insufflation (PACI) is used to improve visualisation and enable complex fetoscopic surgery. However, concerns exist about fetal hypercapnic acidosis and post-operative fetal membrane inflammation. We assessed whether heated-humidified CO would reduce the impact of PACI on the fetus and fetal membranes in sheep. Read More

Acta Neurochir (Wien) 2019 Jan 20;161(1):147-159. Epub 2018 Nov 20.

Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS), Lucknow, 226014, India.

Background: Dynamic magnetic resonance imaging (MRI)-based criteria for diagnosing magnitude of tethered cord syndrome (TCS) in occult spinal dysraphism are proposed.

Methods: In this prospective, case-control design study, MRI lumbosacral spine was performed in 51 subjects [pilot group (n = 10) without TCS (for defining radiological parameters), control group (n = 10) without TCS (for baseline assessment), and study group (n = 31) with spinal dysraphism (thick filum terminale [n = 12], lumbar/lumbosacral meningomyelocoele [n = 6], and lipomyelomeningocoele [n = 13])]. The parameters compared in control and study groups included oscillatory frequency (OF), difference in ratio, in supine/prone position, of distance between posterior margin of vertebral body and anterior margin of spinal cord (oscillatory distance [OD]), with canal diameter, at the level of conus as well as superior border of contiguous two vertebrae above that level; delta bending angle (ΔBA), difference, in supine/prone position, of angle between longitudinal axis of conus and that of lower spinal cord; and sagittal and axial root angles, subtended between exiting ventral nerve roots and longitudinal axis of cord. Read More

World Neurosurg 2019 Feb 15;122:e1338-e1344. Epub 2018 Nov 15.

Department of Pediatric Neurosurgery, Istituto Giannina Gaslini, Genoa, Italy.

Objective: Given the lack of significant responses to many queries regarding behavior, treatment options, and possible prevention of iatrogenic intraspinal inclusion tumors (IITs), we think that further clinical, radiologic, and follow-up data are mandatory to better characterize this entity. We retrospectively reviewed a series of 14 consecutive patients with IIT occurring after myelomeningocele repair. The long follow-up is a mainstay of this series and may help a better understanding of the history of this slow-growing disease. Read More

Crit Care Nurs Clin North Am 2018 Dec 16;30(4):499-507. Epub 2018 Oct 16.

Department of Nursing, Towson University, LI 322, 8000 York Road, Towson, MD 21252, USA. Electronic address:

Advances made in the last several decades in the care of the fetus and newborn have had a significant impact on morbidity and mortality. Delayed umbilical cord clamping in the preterm newborn results in fewer transfusions for anemia, decreased intraventricular hemorrhage, and decreased necrotizing enterocolitis. Because of advances made in fetal ultrasound diagnosis and technological advances, fetal surgeries to treat congenital diaphragmatic hernia, myelomeningocele, twin-to-twin transfusion syndrome, fetal lower urinary tract obstructions, amniotic band syndrome, and congenital cystic adenoid malformation or congenital pulmonary airway malformations have improved the quality of life and survival for these patients. Read More

Fetal Diagn Ther 2018 Nov 14:1-6. Epub 2018 Nov 14.

Department of Obstetrics, Zurich Center for Fetal Diagnosis and Therapy, University Hospital Zurich, Zurich, Switzerland.

Introduction: Despite undoubtable benefits of open fetal myelomeningocele (fMMC) repair, there are considerable maternal risks. The aim of this study was to evaluate and systematically categorize maternal complications after open fMMC repair.

Methods: We analyzed data of 40 fMMC repairs performed at the Zurich Center for Fetal Diagnosis and Therapy. Read More

Ultrasound Obstet Gynecol 2018 Nov 13. Epub 2018 Nov 13.

Baylor College of Medicine, Obstetrics and Gynecology, Houston, TX, USA.

Objective: Cardiac dysfunction has been described in 60% of fetuses undergoing open myelomeningocele (MMC) repair. Routine Doppler evaluation of the umbilical artery (UA) and ductus venosus (DV) is challenging during fetal surgery. The aim of this study was to describe Doppler changes in the UA and DV in a cohort of fetuses during fetoscopic MMC repair. Read More

World Neurosurg 2019 Feb 9;122:278-281. Epub 2018 Nov 9.

Department of Neurosurgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania, USA.

Background: Spinal cord stimulation (SCS) is an evidence-based treatment for chronic neuropathic pain; however, there is a dearth of evidence investigating this modality in patients with tethered cord syndrome.

Case Description: We present a case of 55-year-old woman with history of lipo-myelomeningocele repair and multiple detethering surgeries who presented with chronic low back and leg pain accompanied by progressive gait dysfunction. After a successful trial, she underwent SCS paddle lead placement that resulted in decrease of her visual analog scale for pain from 9/10 to 0-2/10 as well as daily opioid intake from 90 to 199 mg morphine-equivalent doses to 40 to 60 mg morphine-equivalent doses. Read More

J Pediatr Surg 2019 Jan 5;54(1):80-85. Epub 2018 Oct 5.

Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.

Background/purpose: We sought to develop a minimally invasive intra-amniotic therapy for prenatal treatment of myelomeningocele (MMC) in an established rat model.

Methods: Time-dated pregnant rats were gavage-fed retinoic acid to induce MMC. Groups received intraamniotic injections at E17. Read More