Surgeons from the University College Hospital in London (UCHL) and Great Ormond Street Hospital (GOSH) successfully performed corrective surgery on two infants with spina bifida while the patients were still in the womb.
The major surgery involved a 30-strong team guided by UCL professor Anna David, who specializes in structural anomalies in infants and genetic conditions. Her team travelled to Leuven, Belgium to learn the procedure after 40 operations were performed there.
Professor David also worked to import the new procedure to UK hospitals after most parents were forced to travel to Belgium, the US and Switzerland for treatment.
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Research indicates that prenatal corrective surgeries can stop infants from losing spinal fluid, leading to a better quality of life long-term. "It's fantastic. Women now don't have to travel out of the UK," David said in a press statement. "They can have their family with them. There are less expenses."
"In spina bifida, the spinal canal does not close completely in the womb, leaving the spinal cord exposed from an early stage in pregnancy," lead GOSH neurosurgeon Dominic Thompson said, adding that the condition "results in changes to the brain, as well as severe permanent damage to the nerves of the lower half of the body".
"Operating in the womb involves opening the uterus, exposing the spina bifida without delivering the baby, closing the defect and then repairing the uterus to leave the baby safely inside", lead fetal surgeon Jan Deprest of UCLH and Leuven said.
Prenatal spinal bifida surgery improves short and medium-term outcomes, he continued, adding that closing the defect earlier "prevents damage to the spinal cord in the last third of pregnancy".
UK surgeons launched the procedure after a US trial found that the procedure reduced 50 percent of shunts inserted into the brain to drain fluid, leading to long-term complications. Non-shunted children also benefit from the improved brain and motor functioning, researchers said.
"The reduction in need for shunts is particularly important," and long-term monitoring of patients indicated that "brain function, mobility, and total independence were higher in non-shunted than shunted children aged 5," Professor Paolo De Coppi of the UCL Great Ormond Street Institute of Child Health said. De Coppi receives support from the NIHR GOSH Biomedical Research Centre.
"There were some children who had grown up following fetal surgery who were walking, and you wouldn't expect them to be walking if they hadn't had it," Dr. David said. "So it's important to be able to offer the surgery to patients here in the UK."
A newly-established Centre for Prenatal Therapy was established through £450,000 in funding from the hospital's charities and donors, and will treat approved patients.
"These vital funds have provided training for the surgical team and will fund surgery for the first 10 patients," Prof. Donald Peebles, UCLH clinical director for women's health said.
Spina bifida translates to 'split spine' and affects over 200 children each year in the UK, Peterborough-based charity Shine notes. There are roughly five types of condition, based on the severity and location of spinal malformations.
