Spina-bifida babies prospering after in-utero surgery at VUMC
by Nancy Humphrey

Sixteen-month-old Nicholas Garcia was quite smitten with Eileen Vrabcak, R.N.., interim manager of gynecological surgery, at a luncheon last week at The Vanderbilt Clinic. He laughed. He stood on his father’s legs and bounced. He alternated eating a chocolate chip cookie and laughing at Vrabcak’s big smile. To her Nicholas is much more than just an adorable, brown-eyed toddler. He’s a miracle.

Photo by Anne Rayner Daniel Meyer, the first baby to undergo intrauterine surgery to repair spina bifida, makes a handprint with his mother, Cory, right, and Angel Bruner, left.

Nicholas was one of the first babies in the world to undergo pioneering fetal surgery to correct spina bifida in utero. He was the third baby to undergo the procedure in October 1997 and was born five weeks later. He and five other babies, ranging in age from three months to 22 months, returned to VUMC last week for thorough clinical evaluations by a team of Vanderbilt physicians and other health professionals.

During the next six weeks, 25 families will return.

Vrabcak, who has coordinated the surgical team for most of the fetal surgeries, had seen none of the infants since they were born. Only a small portion of their backs had been visible during the procedures. Seeing them smiling, bouncing and walking last week made her cry.

“Seeing these babies is amazing. It touches my heart,” Vrabcak said. “To see these babies and their moms is a miracle. It’s both an ending and a beginning. It’s a closure for the surgery and a new beginning for their lives.”

Joyce Garcia, of Jersey City, N.J., said she is “very happy and very optimistic” about her Nicholas’ progress. “He is doing very well. He started walking about two months ago. We are thrilled.”

The babies underwent X-rays, ultrasound tests and exams during the reunion visit. The Spina Bifida Association of America is paying for the travel, housing and meals for the group.

The reunion gives Vanderbilt a chance to obtain a consistent review of the infants’ progress, said Delia Nickolaus, R.N., case manager of pediatric neurosurgery.

Last week’s group included Daniel Meyer, 22 months old, the first baby to undergo the intrauterine myelomeningocele repair in April 1997. The procedure is performed by Dr. Joseph P. Bruner, assistant professor of obstetrics and gynecology and director of Fetal Diagnosis and Therapy, and Dr. Noel Tulipan, associate professor of neurosurgery.

Zane Gardner, four months old, was the 18th baby to undergo the procedure in September. Born Nov. 12, he is doing well, his parents said.

“His legs, feet and ankles are all moving. He has no bowel or bladder problems,” said Todd Gardner, the baby’s father.

“My boy is going to walk. We are helping him be as normal as he can be. What else can we ask for?”