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February 8, 2021

Long-term Outcomes of Children After Fetal Surgery for Spina Bifida—Toward Sustainability

Author Affiliations
  • 1Department of Pediatric Surgery, University Children's Hospital Zurich, Zurich, Switzerland
  • 2The Zurich Center for Fetal Diagnosis and Therapy, University of Zurich, Zurich, Switzerland
  • 3Children’s Research Center, University Children's Hospital Zurich, Zurich, Switzerland
JAMA Pediatr. 2021;175(4):e205687. doi:10.1001/jamapediatrics.2020.5687

The study by Houtrow et al1 is an eagerly awaited new chapter of an intriguing story that began almost 70 years ago.

In 1956, Cameron published a Lancet article to describe allegedly secondary tissue damage of the openly exposed spinal cord tissue of fetuses and newborn babies with spina bifida (SB) aperta (ie, myelomeningocele or myeloschisis).2 The lesion was characterized by neural tissue damage that was apparently acquired in utero or during birth. This observation did not yet elicit in-depth interpretations regarding the prenatal natural history of SB and possible therapeutic implications.

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    1 Comment for this article
    Lifetime Survival
    Paul Nelson, MS, MD | Family Health Care, PC retired
    As a med-ped Primary Physician from 1975 to 2016, providing health care continuously for two individual persons beginning at birth until 18 years of age, each with a meningomyelocele repaired soon after birth, enhances my view of this report. To offer this level of improvement, especially the improved capability for walking, must have represented a supreme endeavor by all the participant families and their investigational teams. As the data began to evolve, I can't imagine their hopeful and courageous sense of accomplishment.