Spina bifida is a birth defect of the neural tube—the structure in an embryo that develops into a baby’s brain and spinal cord—that occurs during the first month of pregnancy. With spina bifida, part of the neural tube doesn’t close completely, which can damage a baby’s spinal cord and vertebrae. Serious cases can cause loss of movement in the legs and problems with the bowel and bladder.
Depending on the type and severity of the condition, children born with spina bifida typically require surgery to repair it. This can be done as a prenatal operation, or as a postnatal procedure within a few days of the baby being born. Because prenatal surgery is relatively new and not recommended for all cases, postnatal repair surgery is still the most common approach. It is also the only option in many countries where resources are limited.
While performing postnatal repair surgery within the first few days of birth is the standard of care, the exact timing of surgery is not clearly understood, notes University of Iowa Health Care pediatric neurosurgeon Rebecca Reynolds, MD.
“That sparked my interest in better understanding prenatal and postnatal surgeries for spina bifida and who are the best patients for each,” Reynolds says. “How can we best optimize surgery so that the patient has the most successful outcome?”
Reynolds became interested in global medicine during residency training in neurosurgery at Vanderbilt, and in 2019 she was awarded a one-year clinical research fellowship through the National Institutes of Health and its Fogarty International Center. Reynolds and her family moved to Zambia in southern Africa, where she began work at University Teaching Hospital, the nation’s tertiary care center located in the capital city of Lusaka. There, she learned more about the care of spina bifida and the burden of surgical disease in Zambia.
