In Vivo Evaluation of Novel PLA/PCL Polymeric Patch in Rats for Potential Spina Bifida Coverage

OBJECTIVEMyelomeningocele (MMC) is the most common form of spina bifida, with a lifelong impact on the quality of life for infants born with this condition. In recent decades, fetal surgery has evolved from an experimental therapy to standard of care for many centers in the world. In this study, the authors aimed to provide an overview of the current management and outcomes for infants with MMC managed at their institution. This then provides a center-specific historical cohort for comparison with future antenatal-treated MMC cases.METHODSThis is a retrospective, single-institution cohort study including all consecutive MMC cases between January 1, 2000, and June 1, 2018, at Erasmus MC. Outcome data included closure of the defect (location, timing, and surgical parameters), hydrocephalus management, Chiari malformation type II (CMTII) management, incidence of spinal cord tethering and outcome, motor outcomes, and continence.RESULTSA total of 93 patients were included with predominantly lumbosacral lesions. Two patients died during follow-up. Hydrocephalus was present in 84%, with a 71% ventriculoperitoneal shunt reoperation rate. Surgery was performed in 12% for a tethered spinal cord at a mean age of 8 years. Decompression surgery was performed in 3 patients for CMTII. Special education in 63% was significantly associated with hydrocephalus (p < 0.015). Nineteen percent of patients were able to walk independently, and 47% were nonambulators. Social continence for urine was obtained in 75% of patients, 4% had fecal incontinence.CONCLUSIONSThis study provides an overview of current MMC outcomes at the authors’ center and will serve as a historical cohort for comparison with future fetal surgery cases operated on at the center in the coming years. Apart from a relatively low surgical untethering rate, the authors’ outcome data are comparable to those in the literature. Hydrocephalus is highly prevalent in postnatally treated MMC patients; in this study as in much of the literature, hydrocephalus is correlated with a low cognitive function. Fetal surgery for MMC halves the need for shunt treatment in a select group of MMC pregnancies, constituting a major indication for us to undergo the transition to a fetal surgery center. The fetal benefits of open antenatal surgery for MMC are well established, yet long-term data on especially tethered spinal cord are eagerly awaited.

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“…Ongoing research on improvement of fetal surgery for MMC, especially of the fetoscopic technique, is therefore of the utmost importance. 22…”

Section: Tscmentioning

confidence: 99%

Contemporary management and outcome of myelomeningocele: the Rotterdam experience

Spoor¹,

Gadjradj

Eggink³

et al. 2019

Neurosurgical Focus

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“…By blending appropriate rates of PLA and PCL they prepared a polymeric film with a glass transition temperature (T g ) of 37.6 ± 1.28 • C and showing shape-memory behavior in response to external temperature change in the range of the T g value; this property allows unfolding of a coiled scaffold when introduced in the amniotic cavity. In a following paper, the same authors performed an in vivo characterization using a rat model showing that PLA-PCL-blended film did not cause tethering of the cord and did not induce adverse effects on regular functions of the spinal cord [93].…”

Section: Neural Tube Defects Repairmentioning

confidence: 99%

Shape-Memory Polymers Hallmarks and Their Biomedical Applications in the Form of Nanofibers

Pisani

Modena

Dorati

et al. 2022

IJMS

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Shape-Memory Polymers (SMPs) are considered a kind of smart material able to modify size, shape, stiffness and strain in response to different external (heat, electric and magnetic field, water or light) stimuli including the physiologic ones such as pH, body temperature and ions concentration. The ability of SMPs is to memorize their original shape before triggered exposure and after deformation, in the absence of the stimulus, and to recover their original shape without any help. SMPs nanofibers (SMPNs) have been increasingly investigated for biomedical applications due to nanofiber’s favorable properties such as high surface area per volume unit, high porosity, small diameter, low density, desirable fiber orientation and nanoarchitecture mimicking native Extra Cellular Matrix (ECM). This review focuses on the main properties of SMPs, their classification and shape-memory effects. Moreover, advantages in the use of SMPNs and different biomedical application fields are reported and discussed.

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“…, collagen, 7,8 silk fibroin 9 ) have excellent biocompatibility but with poor mechanical properties and complicated purification processes. Synthetic materials such as polycaprolactone (PCL) 10 have good mechanical and degradation properties, but their poor cell affinity and adhesion hamper cell growth and proliferation. 11…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Decellularized materials (e.g., small intestinal submucosa 6 ) and natural materials (e.g., collagen, 7,8 silk fibroin 9 ) have excellent biocompatibility but with poor mechanical properties and complicated purification processes. Synthetic materials such as polycaprolactone (PCL) 10 have good mechanical and degradation properties, but their poor cell affinity and adhesion hamper cell growth and proliferation. 11 In order to overcome these limitations, composite materials constructed by electrospinning technology have been developed.…”

Section: Introductionmentioning

confidence: 99%

Potential use of bioactive nanofibrous dural substitutes with controlled release of IGF-1 for neuroprotection after traumatic brain injury

Wang

Guo

Wang³

et al. 2022

Nanoscale

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In Vivo Evaluation of Novel PLA/PCL Polymeric Patch in Rats for Potential Spina Bifida Coverage

Cited by 19 publications

References 28 publications

Contemporary management and outcome of myelomeningocele: the Rotterdam experience

Contemporary management and outcome of myelomeningocele: the Rotterdam experience

Shape-Memory Polymers Hallmarks and Their Biomedical Applications in the Form of Nanofibers

Potential use of bioactive nanofibrous dural substitutes with controlled release of IGF-1 for neuroprotection after traumatic brain injury

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