Paediatric Orthopaedic Surgery Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
Eur J Obstet Gynecol Reprod Biol. 2011 Jun;156(2):171-6. doi: 10.1016/j.ejogrb.2010.12.046. Epub 2011 Feb 25.
Assess the feasibility of a fetoscopic patch coverage method for myelomeningocele repair in a sheep model.
Experimental study. A myelomeningocele-like defect was created in 15 fetal sheep on day 75 of gestation. Six remained untreated, whereas 9 underwent fetoscopic coverage of the defect on day 95 of gestation using an inert patch secured with surgical sealant. Clinical and histological examinations were performed after delivery.
Four valid newborn lambs were obtained in each group. Mean fetoscopic surgical time was 26.9 (SD=7.4)min. All untreated animals had an open lumbar defect with cerebrospinal fluid leakage, paraplegia, urinary incontinence, and Chiari malformation. All treated animals had a closed defect and were able to walk; one had weak bladder control, and another mild Chiari malformation.
In a chronic myelomeningocele model in fetal sheep, fetoscopic repair using a sealed patch results in simple, fast, satisfactory neural tube closure and averts neurological damage and Chiari malformation.
评估羊模型中使用羊膜镜贴补法修复脊髓脊膜膨出的可行性。
实验研究。在妊娠第 75 天的 15 只胎羊中制造出类似于脊髓脊膜膨出的缺损。6 只未治疗，而 9 只在妊娠第 95 天使用手术密封剂固定的惰性贴补片进行羊膜镜贴补。分娩后进行临床和组织学检查。
每组各有 4 只有效新生羔羊。平均羊膜镜手术时间为 26.9（SD=7.4）分钟。所有未治疗的动物均有开放的腰椎缺损伴脑脊液漏、截瘫、尿失禁和 Chiari 畸形。所有治疗的动物均有封闭的缺损并能够行走；1 只动物膀胱控制较弱，另 1 只动物有轻微的 Chiari 畸形。
在胎羊慢性脊髓脊膜膨出模型中，使用密封贴补片的羊膜镜修复可实现简单、快速、满意的神经管闭合，并避免神经损伤和 Chiari 畸形。
