Philadelphia, Pa. Researchers at The Childrens Hospital of Philadelphia have completed the first study comparing the location on the spine of the birth defect spina bifida with the rate of shunting the surgical placement of a drainage tube. The research showed that infants with spina bifida are more likely to require a shunt when the birth defect is located higher on the spine. The shunt carries excess spinal fluid away from the childs brain to prevent a life-threatening buildup of pressure.
The researchers, led by Leslie N. Sutton, M.D., director of Neurosurgery at Childrens Hospital, reported on 297 children at Childrens Hospital who received surgery shortly after birth to close spina bifida lesions. Overall, 81 percent of the infants required shunts. Our study confirmed the previous widespread impression of neurosurgeons that spina bifida defects closer to the head correspond to a higher incidence of shunting, said Dr. Sutton. The research is published in the March issue of Pediatrics.
In spina bifida, the most common birth defect of the central nervous system, a developmental failure early in pregnancy leaves an opening in part of the bone and tissue covering the fetuss spinal cord. Depending on the severity of the defect, the newborn may suffer paralysis, bowel and bladder problems, and fluid pressure on the brain.
Surgery performed on newborns with open spina bifida lesions requires closing tissue over the defect to protect the spinal tissue. However, previous studies have suggested that neurological injury may occur before or during birth. To prevent that injury, physicians at The Center for Fetal Diagnosis and Treatment at The Childrens Hospital of Philadelphia have performed surgery for spina bifida on the fetus prior to birth.
In a previously published study, Dr. Sutton and his colleagues showed that only one of nine surviving patients who underwent fetal spina bifida surgery required a shunt within 6 months of surgery.
Contact: Lisa Packer
Children's Hospital of Philadelphia