Re-closure by the Skin Graft of the Surgically Induced Spinal Open Neural Tube Defect in Chick Embryos.

Li, Yong Cai; Chung, You Nam; Wang, Kyu Chang

Original Article

Journal of Korean Neurosurgical Society 2003;33(3): 291-296.

Yong Cai Li, You Nam Chung, Kyu Chang Wang

Division of Pediatric Neurosurgery, Laboratory for Fetal Medicine Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.

ABSTRACT

OBJECTIVE
To investigate a re-closure capacity and chronological changes of re-closure, the histologic findings are observed after skin graft on surgically induced spinal open neural tube defect(ONTD) in chick embryos. METHODS: Embryos were divided into two groups: graft and control. In the embryos of the graft, a skin fragment from another chick embryo of embryonic day 7 was grafted on the ONTD immediately after neural tube incision. Embryos were re-incubated in ovo, up to postoperative days(PODs) 3, 5, 7, 10 and sacrificed. Rate of re-closure was compared according to the group of the embryo and the observation time point. Serial changes in histological appearance were observed to investigate whether the re-closured ONTDs regain normal shape. Statistical analysis was performed using the SAS and x2 test. RESULTS: On PODs 3, 5, 7, and 10, re-closure rates of the graft were 87, 60, 53 and 88%, and those of the control were 13, 0, 0 and 20%, respectively. They showed more frequent re-closure of ONTDs by the skin allograft in the graft than control. There was no statistical difference between the closure rates of adjacent POD subgroups. Some embryos of the closed groups revealed complete closure of the neural tube and there was no difference from the normal neural tube. CONCLUSION: Skin graft on the surgically induced ONTD in the embryonic period has a protective effect on the spinal cord. It is suggested that the prenatal skin graft on the lesions of fetal myelomeningocele might prevent repeated spinal cord damage.

Key Words: Open neural tube defect; Surgery; Skin graft; Re-closure; Chick embryo