Prenatal and Postnatal Imaging Findings After Fetal Repair of Spinal Dysraphisms Using Cryopreserved Human Umbilical Cord Patch: A Case Series of 4 Patients

Abstract

We describe a case series of imaging findings of 4 patients who underwent spinal dysraphisms repair in utero with novel patch material, cryopreserved human umbilical cord, in our institution. In our study, the prenatal and postnatal magnetic resonance imaging and ultrasound are reviewed and showed cord tethering and syrinx progression in all cases. Our report is the first description of magnetic resonance imaging and ultrasound findings in the context of using this novel patch in severe cases of spinal dysraphisms.

The impact of a biocellulose-based repair of fetal open spina bifida on the need to untether the cord: is it time to unify techniques for prenatal repair?

“…We demonstrated that these grafts adhered to the placode, whereas biocellulose did not. ( 26 ) Recently, other products have been investigated, such as the human umbilical cord matrix ( 34 ) and synthetic biodegradable patch; ( 35 ) however, their efficacy has not been proven.…”

Primary vs patch‐based skin closure for in‐utero spina bifida repair

“…Limited clinical data are available in relation to in‐utero patch‐based repair of SB 9,12,13 . Lapa Pedreira et al 12 .…”

“…However, there are no established methods to determine the complications related to patch-based closure until delivery or at longer follow-up. Limited clinical data are available in relation to in-utero patch-based repair of SB 9,12,13 . Lapa Pedreira et al 12 reported their experience with using a bilaminar skin substitute in addition to a biocellulose patch for fetoscopic closure of SB repair.…”

“…Imaging studies have suggested that in-utero patchbased repair of SB may be associated with cord tethering with variable development of thick fibrous bands in the lumbosacral canal 13 . However, we did not find an increased risk for surgery for tethered cord in our cohort, even though imaging studies were not available to review 1-year outcomes.…”