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Acquired spinal cord injury in human fetuses with myelomeningocele.
Pediatr Pathol Lab Med 1996 Sep-Oct; 16(5):701-12PP

Abstract

Experimental studies have shown that there is a potential to attempt in utero repair of myelomeningocele in human fetuses. To provide a better understanding of the pathology of these lesions we prospectively studied eight stillborn human fetuses with myelomeningocele autopsied at The Johns Hopkins Hospital. The intact vertebral column with surrounding structures was removed, processed as a single block, and prepared as serial histologic sections. Study of the slides showed in all cases that in the center of the myelomeningocele the vertebral arch was open, the arrangement of meninges was such that the dura mater was open and in continuity with the deep layers of the dermis, and the pia mater was open and in continuity with a layer consisting of the superficial dermis and the epidermis. These meningeal relationships created an abnormally configured arachnoid space containing cerebrospinal fluid ventral to the spinal cord, which rested on the open pia mater and was exposed on the dorsal aspect of the sac. At the level of the myelomeningocele the naked cord had undergone varying degrees of injury up to complete loss of neural tissue. Where ventral remnants of the cord remained it was evident that a large degree of normal development of the cord had occurred. In most instances it appeared that the injury or destruction of the dorsal spinal cord was recent and consistent with occurrence during delivery. The results of this study support the concept that in utero surgery could preserve and protect the exposed spinal cord in a myelomeningocele of a human fetus and thus could reduce the severity of the neurologic deficit at birth.

Authors+Show Affiliations

Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9025869

Citation

Hutchins, G M., et al. "Acquired Spinal Cord Injury in Human Fetuses With Myelomeningocele." Pediatric Pathology & Laboratory Medicine : Journal of the Society for Pediatric Pathology, Affiliated With the International Paediatric Pathology Association, vol. 16, no. 5, 1996, pp. 701-12.
Hutchins GM, Meuli M, Meuli-Simmen C, et al. Acquired spinal cord injury in human fetuses with myelomeningocele. Pediatr Pathol Lab Med. 1996;16(5):701-12.
Hutchins, G. M., Meuli, M., Meuli-Simmen, C., Jordan, M. A., Heffez, D. S., & Blakemore, K. J. (1996). Acquired spinal cord injury in human fetuses with myelomeningocele. Pediatric Pathology & Laboratory Medicine : Journal of the Society for Pediatric Pathology, Affiliated With the International Paediatric Pathology Association, 16(5), pp. 701-12.
Hutchins GM, et al. Acquired Spinal Cord Injury in Human Fetuses With Myelomeningocele. Pediatr Pathol Lab Med. 1996;16(5):701-12. PubMed PMID: 9025869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acquired spinal cord injury in human fetuses with myelomeningocele. AU - Hutchins,G M, AU - Meuli,M, AU - Meuli-Simmen,C, AU - Jordan,M A, AU - Heffez,D S, AU - Blakemore,K J, PY - 1996/9/1/pubmed PY - 1996/9/1/medline PY - 1996/9/1/entrez SP - 701 EP - 12 JF - Pediatric pathology & laboratory medicine : journal of the Society for Pediatric Pathology, affiliated with the International Paediatric Pathology Association JO - Pediatr Pathol Lab Med VL - 16 IS - 5 N2 - Experimental studies have shown that there is a potential to attempt in utero repair of myelomeningocele in human fetuses. To provide a better understanding of the pathology of these lesions we prospectively studied eight stillborn human fetuses with myelomeningocele autopsied at The Johns Hopkins Hospital. The intact vertebral column with surrounding structures was removed, processed as a single block, and prepared as serial histologic sections. Study of the slides showed in all cases that in the center of the myelomeningocele the vertebral arch was open, the arrangement of meninges was such that the dura mater was open and in continuity with the deep layers of the dermis, and the pia mater was open and in continuity with a layer consisting of the superficial dermis and the epidermis. These meningeal relationships created an abnormally configured arachnoid space containing cerebrospinal fluid ventral to the spinal cord, which rested on the open pia mater and was exposed on the dorsal aspect of the sac. At the level of the myelomeningocele the naked cord had undergone varying degrees of injury up to complete loss of neural tissue. Where ventral remnants of the cord remained it was evident that a large degree of normal development of the cord had occurred. In most instances it appeared that the injury or destruction of the dorsal spinal cord was recent and consistent with occurrence during delivery. The results of this study support the concept that in utero surgery could preserve and protect the exposed spinal cord in a myelomeningocele of a human fetus and thus could reduce the severity of the neurologic deficit at birth. SN - 1077-1042 UR - https://www.unboundmedicine.com/medline/citation/9025869/Acquired_spinal_cord_injury_in_human_fetuses_with_myelomeningocele_ L2 - https://ClinicalTrials.gov/search/term=9025869 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -