The treatment seeks to repair fetal spines and heal damage done in the womb

Admin on 11 / 05 / 2026 under #uterus #spinal #womb

The new technique attempts to heal nerve damage caused by spina bifida, a disabling birth defect. In this condition, the bony tissue of a fetus’s spine doesn’t knit together properly around the spinal cord. That can cause a kaleidoscope of medical issues, including lifelong paralysis and bladder and bowel problems.

Traditional fetal surgery to patch up the spine can limit the scope of these problems — but it does not repair nerve damage that has already occurred. Adding living stem cells to the procedure might.

At least, that’s the goal of fetal surgeon Diana Farmer’s team. So far, the approach appears to be safe, the researchers reported earlier this year in theLancet. In six fetal patients with severe spina bifida, applying a stem cell–loaded patch to their exposed spinal cords did not cause infection, tumor growth or interfere with healing. That’s important because “no one knew what stem cells would do inside a fetus,” says Farmer, of the University of California, Davis.

For now, the vital question — whether the technique mends fetal spinal cords — remains unanswered. That’s because researchers are still performing follow-up assessments of the patients, who are now toddlers. At this stage, it’s too early to say how well the surgery worked, and Farmer is careful not to speculate. “If we could get every kid to not be in a wheelchair,” she says, “that would be fantastic.” But the team won’t know for a few years. Until then, Farmer says, she doesn’t want to give people false hope.

In some ways, this study represents “a seismic shift” in the field, says Ramen Chmait, director of Los Angeles Fetal Surgery at the University of Southern California, who was not involved with the work. If the technique pans out, he says, it “could be a huge, important step in modern-day medicine.”

Maternal fetal medicine specialist Magdalena Sanz Cortes echoes the sentiment in a commentary that accompanied Farmer’s study. “We eagerly await follow-up results and definitive studies that might show benefit,” writes Sanz Cortes, of Baylor College of Medicine in Houston. “Such results would herald a new era in fetal surgery.”

First, doctors will need to better understand the procedure’s risks and benefits. At this point, Chmait says, Farmer’s team has taken the “first step of a marathon.”

Spina bifida can be repaired in the womb, but there’s room for improvement.

In the United States, roughly 1 in every 2,800 babies are born with spina bifida. This abnormality leaves the delicate spinal cord exposed in the womb. Without the bony protection of the vertebrae, the spinal cord can bulge through the back, making it especially vulnerable to injury. Like a chemical that burns, amniotic fluid washing over the open spinal cord can degrade it. And as the baby grows, it rubs against the walls of the uterus, damaging unprotected nerve cells.

Beyond paralysis and other serious problems, this damage can cause fluid to build up in the brain. Some babies require a shunt surgically implanted in the days or weeks after birth for drainage. That can be lifesaving, but it’s also lifelong ¬— a permanent implant that can malfunction or spur infection.

One way to avoid the shunt, and potentially some of the nerve damage accrued during pregnancy, is to surgically close the hole in the fetus’s spine in the womb. That was the conclusion of a landmark clinical trial 15 years ago that compared surgery done before and after birth. Prenatal surgery cut the need for shunts in half and doubled the chance of being able to walk without leg braces or other devices, Farmer’s team reported in the New England Journal of Medicine.