In October 2018, a revolutionary surgery was performed on babies whilst they were still in the womb, correcting their spine after a rare condition caused spinal deformities. The surgeries were a success, preventing likely paralysis once they were born, alongside preventing a host of other severe complications.
Now, the surgery has been rolled out across the UK, and the NHS reports that it has been performed on 32 babies since Jan 2020. The incredible surgery takes up to 30 specialist medical professionals in the operating theatre, and involves operating on the developing fetus from just 5 months into the pregnancy.
Spina bifida is a form of neural tube defect that can affect any point along the spine, in which the backbone doesn’t close properly. This may lead to damage to the nerves around it, including the spinal cord, as well as leaving these nerves exposed and vulnerable. It can range in severity and cause a host of mental and physical disabilities, with serious cases causing paralysis.
Previous to the ground-breaking keyhole surgery, most babies with spina bifida had to undergo surgery within 48 hours of birth. If successful, the surgery would fix any protruding nerves and repair the spinal cord – but any nerve damage that has occurred during development was permanent. As such, fixing the defect as early as possible is imperative.
The new surgery is a keyhole surgery, in which small instruments are passed through a tiny incision into the womb. From here, the opening from which the spinal cord is protruding is identified and it is inserted back into the fetus, and it is then repaired. It is not without risks, but the benefits are enormous.
Currently, the operation is offered as a collaboration between centers in Belgium and London, as the wealth of knowledge required means it can only be provided at selected centers.
“Spina bifida fetal surgery where neurosurgeons carry out complex spinal surgery on an unborn baby is routinely available on the NHS, and is just one example of the NHS leading innovative treatments across the world,” said Professor Stephen Powis, Medical Director for NHS England, in a statement.
“As well as fighting a global pandemic the NHS continues to develop and offer these trailblazing services and continue to be there for patients.”
The NHS even provides a heart-warming example of the surgery making a huge difference in the lives of children and their families. Helena Purcell underwent the operation whilst 23 weeks pregnant after her unborn child was diagnosed with spina bifida. Following the surgery, the baby is doing extremely well, with movement in her legs, control over bowel movements, and a much-lowered level of fluid in the brain – fluid accumulation in the brain is a symptom consistent with spina bifida. Due to excess fluid, people with spina bifida often need a series of operations to drain it, called shunt placement. Fortunately, the new surgery has demonstrated to reduce the need for shunt placement by up to 50 percent.
