Peters, Xiao and the All Children's surgeons will speak at the First World Conference on Spina Bifida Research this week in Orlando.
By telephone last week, Peters called the results of the pilot at Beaumont "mixed."
Twelve children got the surgery — three with spinal cord injuries, nine with spina bifida. The three with spinal cord injuries were not helped by the procedure. Seven of the nine with spina bifida saw "marked improvement." One of them was a "home run," a girl who achieved complete continence.
Peters said the major complication was leg weakness that developed among eight of the nine with spina bifida. All had been able to walk before the surgery. They often required intense physical therapy, Peters said, "just to get them back to baseline." One child developed drop foot, meaning he could not raise his foot when he walked.
"We knew there could be complications going in," he said, "but it was still frustrating."
When Peters addresses the conference this week, he will emphasize caution. Parents are desperate for help, he said. But because of the unknowns, "if a parent walked into my office and stuck $50,000 in my face, I'd have to say no."
The surgeries should continue, he said, only under the strictest research protocol until U.S. doctors see the kind of results that Xiao reports in China. Beaumont will perform four more Xiao procedures in May.
Peters: "Do the benefits outweigh the risks? I'm not ready to say that. It's very easy to be wowed by it. I was wowed in China when I saw Dr. Xiao's data. I'm still wowed, but my 'wow' is a little more tempered."
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The cautious findings in Beaumont and virtual absence of other U.S. data prompted intense debate at All Children's. Urologist Homsy said the three-year study had to go before the hospital's Institutional Review Board and was okayed only after lengthy review and a set of strict research conditions.
Most of the children being chosen are already in wheelchairs, so complications of leg weakness and drop foot will be less of a concern.