[needlesurgeon]

Neurosurgeon here (long-term HN browser and my post).

If you're interested in prenatal surgery for spina bifida (more specifically: for myelomeningocele), check out the MOMS trial:

https://www.nejm.org/doi/full/10.1056/NEJMoa1014379

Essentially, this was a prospective randomized trial looking at prenatal surgery vs. standard management with mothers who knew they were going to have a child with spina bifida.

This work stems from pre-clinical experiments using sheep:

https://www.ncbi.nlm.nih.gov/pubmed/7585064

[escapologybb]

I almost certainly know the answer to this question and understand you're not my doctor et cetera et cetera et cetera and I won't try to do something Internet crazy when you tell me it's not possible.

(Deep breath)

That being said, Do you think hypothetically that this type of surgery could be used to help dashingly handsome 41-year-old Quadriplegic hackers with spina bifida like me?

(also, been interacting with neurologists my entire life and I think your understanding of the brain borders on the magical dark arts!)

[needlesurgeon]

When we talk about clinical trials, we are often interested in answering (1) a primary outcome, which is articulated as a specific yes/no questions based on a measurable clinical outcome, and then (2) a series secondary outcomes, which are answers to auxiliary answers. Clinical trials are usually designed to answer a specific question for a specific population.

Many (actually, most) children born with myelomeningoceles will develop hydrocephalus, which is a mismatch between spinal fluid production and resorption. This is usually treated using a ventriculoperitoneal shunt -- a shunt that diverts fluid from the brain to the abdominal cavity. Shunts can be life saving, but most eventually stop working and need to be surgically revised.

The MOMS trial compared the need for VP shunt and mortality between pre-natal surgery and the standard practice (i.e. post-natal surgery). So: unfortunately, the results of this trial do not generalize to your situation.

However, many academic medical institutions with neurosurgical and rehab departments have ongoing studies related to spinal cord injuries. There are a variety of surgeries that can help people with spinal cord dysfunction who have specific clinical problems (e.g. bladder control, contractures, etc.).

There are also clinical trials that have looked at restorative neurotechnologies for people with spinal cord dysfunction. For instance, check out:

https://www.ncbi.nlm.nih.gov/pubmed/30382196

https://www.ncbi.nlm.nih.gov/pubmed/30462658