Objective: Chemical and mechanical injury in myelomeningocele (MMC) during the fetal life results in functional disorders of multiple organs. Prenatal MMC repair reduces sequelae of spinal cord injury.

Design: Histopathological evaluation of dura mater and skin specimens to assess the severity of inflammatory changes.

Setting: Histopathological laboratory and operated patients.

Participants: 45 cases (Group I)-intrauterine surgery due to MMC and 42 cases (Group II)-postnatal surgery.

Outcome measures: Specimens of the skin and of the dura mater adjacent directly to the uncovered section of the spinal cord were collected for assessment. The specimens were histopathologically evaluated to assess the severity of inflammatory changes.

Results: The analysis of the severity of inflammatory changes in the skin and the dura mater showed only small lymphocytic infiltration in 5 fetuses (Group I). Medium and large infiltration in the skin and the dura mater was found in all children who underwent postnatal surgery (Group II). Lymphocytic and granulocytic infiltration in the skin and the dura mater were statistically significantly more prevalent in children who underwent postnatal surgery compared to the group of children who underwent prenatal surgery (P < 0.000003).

Conclusions: By reducing the time of exposure to damaging factors, prenatal MMC repair statistically reduces the risk of inflammatory changes in the exposed spinal cord and spinal nerves. Prenatal closure of spina bifida before 24 week of gestation does not reduce the severity of inflammatory changes in the exposed spinal cord.

目的：胎儿期脊髓脊膜膨出（MMC）的化学和机械损伤导致多器官功能障碍。产前 MMC 修复可减少脊髓损伤的后遗症。

设计：对硬脑膜和皮肤标本进行组织病理学评估，以评估炎症变化的严重程度。

设置：组织病理学实验室和手术患者。

参与者： 45 例（I 组）-由于 MMC 引起的宫内手术和 42 例（II 组）-产后手术。

结果测量：收集直接与未覆盖的脊髓部分相邻的皮肤和硬脑膜样本进行评估。对标本进行组织病理学评估以评估炎症变化的严重程度。

结果：对皮肤和硬脑膜炎症变化严重程度的分析显示，5 个胎儿（I 组）仅有少量淋巴细胞浸润。在所有接受产后手术的儿童中发现皮肤和硬脑膜中、大面积浸润（第 II 组）。与接受产前手术​​的儿童组相比，接受产后手术的儿童皮肤和硬脑膜的淋巴细胞和粒细胞浸润在统计学上更为普遍（P < 0.000003）。

结论：通过减少暴露于破坏性因素的时间，产前 MMC 修复在统计学上降低了暴露的脊髓和脊神经发生炎症变化的风险。在妊娠 24 周之前产前关闭脊柱裂不会降低暴露脊髓炎症变化的严重程度。