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Advances in the prevention and prenatal treatment of spina bifida
Zachary B Sluzala1, Katrina E Furth1,2
1Charlotte Lozier Institute, Arlington, VA 22206, USA.
Insights
Spina bifida, a neural tube defect, is increasingly managed through advances like folic acid prevention and in-utero surgery. Future treatments involve stem cells and robotics to improve lifelong health outcomes.
Area of Science:
- Neurology
- Developmental Biology
- Surgical Innovation
Background:
- Spina bifida is a severe neural tube defect impacting fetal development.
- Myelomeningocele (MMC) is the most common form, causing significant motor, sensory, and organ-specific challenges.
- Associated conditions include renal, urological, orthopedic, developmental, and psychosocial issues.
Purpose of the Study:
- To review the etiology, pathogenesis, prevention, diagnosis, and management of spina bifida.
- To highlight advancements in in-utero surgical repair for myelomeningocele.
- To discuss emerging technologies redefining treatment goals and improving patient outcomes.
Main Methods:
- Comprehensive literature review on spina bifida research and clinical practice.
- Analysis of historical and current prevention strategies, including folic acid supplementation.
- Evaluation of diagnostic advancements and evolving surgical techniques, including hybrid approaches.
Main Results:
- Folic acid supplementation has substantially decreased spina bifida incidence.
- Prenatal imaging and diagnostics enable earlier detection and intervention.
- In-utero surgery, including innovative hybrid methods, shows evolving efficacy.
Conclusions:
- Significant progress has been made in spina bifida care, from prevention to postnatal management.
- Emerging technologies like stem cell therapy, biomaterials, and robotic surgery promise further improvements.
- Continued innovation aims to enhance long-term health and quality of life for individuals with spina bifida and their families.
Abstract:
Spina bifida is a neural tube defect (NTD) that arises when the neural tube fails to close properly during early development. This review focuses on myelomeningocele (MMC), the most common severe form of spina bifida, which often leads to motor and sensory impairments, including lower limb weakness or paralysis, as well as renal, urological, orthopedic, developmental, and psychosocial challenges. We explore the etiology, pathogenesis, prevention, diagnosis, and management of spina bifida, with a special emphasis on in-utero surgical repair. Over the past several decades, researchers and clinicians have made remarkable strides across all stages of care from prevention to postnatal outcomes. Widespread use of folic acid supplementation has significantly reduced the number of new cases. Advances in prenatal imaging and diagnostics now allow for earlier and more accurate detection, enabling timely intervention. In-utero surgical techniques continue to evolve, with innovative hybrid approaches that combine the strengths of open and minimally invasive methods. The momentum in this field shows no sign of slowing. Promising developments in stem cell therapy, biomaterials, robotic-assisted surgery, 3D printing, and enhanced imaging are redefining treatment goals in spina bifida. With each advance, clinicians gain better tools to improve outcomes for both mother and child, minimizing risks and maximizing long-term health and quality of life for both patients.
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