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J Pediatr Surg ; 41(6): 1125-9, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16769346

RESUMO

BACKGROUND/PURPOSE: Recent experience in fetal surgery to correct myelomeningocele in humans reports an early reversion of hydrocephalus and decreased need of ventricular shunting in the first months of life; however, it has not been possible to demonstrate benefit in lower extremity function. In the present work, we have tried to ascertain the impact of cord exposure on hind limb function. METHODS: Fetal rabbits with myelomeningocele (group M), treated myelomeningocele (group T), and control animals (group C) were compared at birth regarding physical examination, somatosensory-evoked potentials of the hind limbs, ventricular morphometry, and spine histology. RESULTS: No major difference was found between groups M and T in the physical examination. Somatosensory-evoked potentials of the hind limbs were absent in group M and present in group T, although showing a longer latency period and decreased amplitude than controls. The area of the third ventricle was significantly larger in group M than in group C; in group T, it was also somewhat larger but not significantly so. Cord histology had evident changes in group M and minor changes in group T, which resembled normal group C cord. CONCLUSIONS: Prenatal covering of the spinal cord prevents central and peripheral neurologic deterioration in this animal model of myelomeningocele.


Assuntos
Doenças Fetais/cirurgia , Meningomielocele/embriologia , Meningomielocele/cirurgia , Doenças do Sistema Nervoso/prevenção & controle , Medula Espinal/embriologia , Retalhos Cirúrgicos , Animais , Animais Recém-Nascidos , Ventrículos Cerebrais/patologia , Embrião de Mamíferos/cirurgia , Potenciais Somatossensoriais Evocados , Membro Posterior/fisiopatologia , Meningomielocele/patologia , Lobo Parietal/fisiopatologia , Período Pós-Operatório , Coelhos , Tempo de Reação , Medula Espinal/patologia
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