At the Bedside: First baby to receive novel spina bifida surgery at UTHealth Houston thriving 6 months after treatment

Nova received an experimental spina bifida surgery at UTHealth Houston on Sept. 2, 2025. (Photo by Cristiam Herrera)

Looking back, Cristiam and Maxine Herrera say that the car accident they were involved in on Easter in 2025 was actually a blessing. 

They weren’t injured, but Maxine was about four months pregnant at the time, so they headed to a hospital in San Antonio, Texas for a precautionary ultrasound. The procedure showed that her son, Nova, likely had a hole on his spinal cord, a condition known as spina bifida. 

Spina bifida is typically treated through fetal surgery or a postpregnancy surgery that involves using artificial material to close the opening on the spine. For 1 in every 2,875 babies born each year with the disease, symptoms can range from mild to severe physical and mental disabilities requiring long-term treatment from physical therapists, neurologists, urologists and nutritionists, among other specialists. 

When Maxine and her husband returned to their home in Katy, Texas, their OB/GYN confirmed the results of the San Antonio ultrasound, and the couple was referred to the UTHealth Houston Fetal Center. 

“If it wasn't for the car accident, us getting checked out, who knows when this would have been caught,” Cristiam said. 

Though Maxine wasn’t eligible for fetal surgery, a UTHealth Houston team was recruiting patients for a groundbreaking, experimental new treatment option when Cristiam and Maxine arrived.

“They just happened to be the right people at the right time,” said KuoJen Tsao, MD, co-director of The Fetal Center.

Tsao, who is also chief of the Division of Pediatric General and Thoracic Surgery and holds the Children’s Fund, Inc. Distinguished Professorship in Pediatric Surgery at McGovern Medical School at UTHealth Houston, is among a team of researchers exploring whether long-term outcomes in babies born with spina bifida can be improved by repairing spinal cord holes using umbilical cord tissue. 

“If you can use your own tissue instead of using donor tissue, it’s always better,” Tsao said. “Being the first patient, you always want to make sure you could do it safely and well, and not take on a terribly difficult case. They were a pretty straightforward case.”

Cristiam and Maxine were initially emotional about Nova’s diagnosis. But they were told that the hole in Nova’s spine was relatively small, and that he’d likely fare well. They quickly went into preparation mode, learning about the condition and taking careful notes from their team at The Fetal Center about what to expect for their son. 

When Nova was offered the chance to be the first baby to receive the experimental surgery, Maxine and her husband agreed. 

“I was like, ‘Let’s do it,’” Maxine, a registered nurse, recalls. “‘We should try.’” 

Practice makes perfect

Ahead of Nova’s surgery, researchers conducted several practice sessions to prepare for the unique steps required of the experimental treatment. These sessions started with a team assisting with a birth in the delivery room. 

Then, a team led by Charles Cox Jr., MD, professor of pediatric surgery and director of the Program in Children’s Regenerative Medicine at McGovern Medical School, would practice processing the baby’s umbilical cord and creating the roughly two-by-three-inch patch. 

Nova continues to thrive six months after his spina bifida surgery at UTHealth Houston. (Photo by Cristiam Herrera)

That work is conducted in a sterile lab attached to the delivery room and developed with the help of Cox, who holds the George and Cynthia Mitchell Distinguished Chair in Neurosciences, the Glassell Family Distinguished Chair, and the James H. "Red" Duke, Jr., MD, Distinguished Professorship in Surgery. The vacuum-sealed space allows the patch to be created under the cleanest and safest possible conditions. 

Tsao said these “dry-runs” were important. They helped the team understand the timing of events before the patch would be implanted by Stephen Fletcher, DO, pediatric neurosurgeon and professor in the Department of Pediatric Surgery at the medical school. Fletcher also holds the Dr. Marnie Rose Professorship in Pediatric Neurosurgery. 

“We wanted everybody to understand what they needed to do so that we could coordinate,” said Tsao, whose role in the project has been bridging the experience between Cox and Fletcher’s teams. 

Flourishing against the odds

When it came time for Nova’s surgery on Sept. 2, 2025, Maxine wasn’t nervous. 

“I knew for sure he was in good hands,” Maxine said. 

About 15 minutes after Maxine’s C-section, Nova was whisked away to the operating room.

Cristiam battled his nerves in the hallway. An hour and a half later, the operation was declared a success. Nova spent the next two weeks in the NICU while Maxine recovered at home. 

“The majority of the time Nova was in the NICU, he was on his stomach,” Cristiam said. “Of course, babies want to be swaddled. He couldn’t do any of that, and we couldn’t do any of that to him. That was very emotional.” 

But on the 13th day, Nova was cleared to leave. Aside from typical wound care, Cristiam and Maxine were told to treat Nova as if he were any other newborn. 

Six months after his surgery, Nova continues to flourish. 

“All the negative things that could have occurred with someone having spinal bifida – lack of leg movement, unable to go to the restroom and do things on their own – he’s done the opposite,” Cristiam said. “We always joke that when the doctors said that he may not be able to kick, Nova took that personally, and he started just showing off that he could kick and move.” 

Nova will continue to see a range of doctors in The Fetal Center, Tsao said. 

“The concept of using the baby’s own tissue to repair part of the body is not a new thing. We sort of equate it to taking a skin graft,” Tsao said. “The research is really in the long-term follow-up to see how babies are doing.” 

Tsao and the team plan to treat about 10 babies with the umbilical cord patch, who will be monitored for several years to assess long-term outcomes. 

“Some of the things that we’re interested in, we’re not going to be able to tell until a little bit later in life,” Tsao said. “It’s important for us to find the right families that are going to commit to us as we’re committing to them.”