Table 3.

Patches used during tissue engineering approaches to repair and regeneration neural function after spina bifida repair

Material class	Material subclass	Patch component	Bioactive delivered	Animal model	Key findings	Reference
Synthetic	Polyester	Poly(F-lactide-co-caprolactone) + polyfpropylene glycol) + sodium acetate nanofibrous scaffold	iPSC neural crest stem cells	Surgically induced lamb MMC	Demonstrated integration of transplanted cells within the spinal cord	[64]
Natural	Porcine	Small intestine submucosa-derived extracellular matrix	Placenta-derived mesenchymal stromal cells	Surgically induced lamb MMC	Lambs repaired with patch and underwent postnatal bracing and physical therapy survived for 6 months after delivery and obtained rescued mobility compared to those without physical therapy	[65]
				Surgically induced lamb MMC	Cell treatment improved motor function compared to animals that only received the ECM patch and was associated with large neuron density	[66]
				Surgically induced lamb MMC	Repair of MMC with high density cell treatment led to improved motor function and was associated with an increase in neuron density	[67]
				Retinoic acid-induced MMC in fetal rats	Spinal cord compression was reduced in animals treated with ECM and cells	[68]
				Surgically induced lamb MMC	Fetal viability, ambulation, and neuron densities were greater in animals treated with ECM and cells	[69]
		Dermis derived gelatin + chitosan scaffold	Bone marrow mesenchymal stem cells	Retinoic acid induced MMC in fetal rats	Stem cell transplant was associated with decreased defect size, stem cell survival and neuron regeneration in the defect site	[70]
	Bovine	Dermis derived gelatin + bone derived collagen sponges	Basic fibroblast growth factor	Retinoic acid induced MMC in fetal rats	Release of bFGF from the sponge increased neovascularization and tissue incorporation	[71]
				Surgically induced lamb MMC	Release of bFGF from the sponges enhanced epithelialization, inhibited spinal cord damage, and reversed hindbrain herniation	[72]
		Artificial skin (bovine type 1 collagen gel)	Induced pluripotent stem cell derived keratinocytes	Retinoic acid induced MMC in fetal rats	12/20 animals obtained partial or full defect coverage; however, there was not a significant difference in defect size with therapy	[73]
	Rat	Rat tail collagen gel	Placenta-derived mesenchymal stromal cells	Surgically induced lamb MMC	Cells and collagen treatment improved motor outcomes and neuron quantity compared to collagen alone	[74]
	Human	Amnion	Placenta derived mesenchymal stromal cells	Surgically induced lamb MMC	Repair with amnion plus placental derived mesenchymal stromal cells from early-gestation placenta led to much improved motor function compared to term-gestation placenta	[75]
		Dermal matrix (Alloderm)	Neural stem cells	Surgically induced lamb MMC	Neural stem cells transplanted on Alloderm remained undifferentiated and produced important neurotrophic factors at the defect site	[76]
		Fibrin hydrogel	Rat neural progenitor cells	Retinoic acid-induced MMC in fetal rats	Hydrogel treatment correlated with increased neuronal maturation	[77]