Improving Motor Function in Fetal Surgery for Open Spina Bifida

( BJOG . 2024;131:768. doi: 10.1111/1471-0528.17730) The mini commentary describes progress in fetal surgery for open spina bifida (or myelomeningocele, known as MMC), with a primary emphasis on enhancing motor function results. Prenatal surgery for MMC has been widely embraced as the preferred treatment option following the 2011 Management of Myelomeningocele Study (MOMS) clinical trial, leading to enhanced brain and motor function outcomes compared to postnatal surgery. Nevertheless, numerous children encounter obstacles, including mobility limitations and the requirement for daily urinary catheterization, which impacts their quality of life. Spinal cord tethering often occurs after surgery due to fibrosis and inflammation near the repair site of the MMC, which has prompted researchers to investigate ways to enhance surgical outcomes through neuroprotective and immunomodulatory strategies.