Olivia Bell ’27
Craniosynostosis (CS) is a congenital condition characterized by the premature fusion of cranial sutures due to abnormal developmental pathways (Governale et al., 2015). This fusion can lead to increased intracranial pressure, cognitive impairment, and visible skull deformities. Current treatments include helmet therapy and minimally invasive surgical procedures. However, re-craniosynostosis can occur, limiting the long-term effectiveness of surgery. In addition, these procedures are associated with significant financial costs and carry risks such as substantial blood loss. Through the Princeton IIP program, I had the opportunity to research sustainable alternatives for CS treatment.
The BIOMET4D project investigates biodegradable, load-bearing metallic biomaterials as implants for orthopedic applications. Under the supervision of Dr. Jennifer Patterson at the IMDEA Materials Institute (Biomaterials and Bioengineering Group), my research evaluated the degradation behavior and biocompatibility of various metallic implants. This work contributes to the broader objective of developing biodegradable implants that eliminate the need for secondary surgeries, advancing sustainable, patient-centered solutions in biomedical engineering.
The cytotoxic behavior of these biomaterials was assessed through abnormal ion concentrations measured by Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES), deviations in pH from physiological ranges, and metabolic activity changes of cells exposed to the metallic disks. Additionally, I contributed to the histological evaluation of tissue samples collected from in vivo experiments performed before my internship. Toxicity was determined by identifying pathological markers such as necrosis, inflammation, and nuclear pyknosis. My role involved analyzing pre-stained, imaged tissue sections to evaluate in vivo complications and to support the overall assessment of material biocompatibility. The internship at IMDEA challenged me to reconcile the promise of biodegradable metals with the realities of biological safety. For example, magnesium alloys generally degrade rapidly, producing ion imbalances and pH shifts that compromise cell health. Confronting potential trade-offs such as this taught me that meaningful progress in biomaterials requires technical advancements, as well as adaptability in the face of unexpected results. I came away with a deeper appreciation for how setbacks can drive new questions and ultimately shape more sustainable solutions.
Building on my prior experience treating orthopedic conditions in children, I had the opportunity to shadow Dr. Tracy Flanders, a pediatric neurosurgeon at the Children’s Hospital of Philadelphia (CHOP). Dr. Flanders specializes in the diagnosis and treatment of spinal dysraphism—including tethered cord syndrome (TCS), a subcategory of this disorder—as well as hydrocephalus, among other conditions. TCS occurs when the spinal cord is abnormally attached to surrounding tissue, causing it to stretch and potentially leading to neurological and orthopedic complications (Sysoev et al., 2017).TCS can be diagnosed at any age and typically does not require surgical intervention, referred to as “cord untethering”, unless symptoms are present. Common symptoms include a sacral dimple, a patch of hair over the lower spine, urinary incontinence, abnormal genital sensations, equinus deformities, or lower back and leg pain. During my time at CHOP, I observed a spinal cord untethering surgery performed by Dr. Flanders. While there is ongoing debate within the pediatric neurosurgical community regarding the timing of untethering, Dr. Flanders and her colleagues at CHOP generally recommend the procedure if the tethering extends beyond the L3 level of the spinal column and no fat is present. Revision surgery may be required if cerebrospinal fluid (CSF) leaks into the incision, as this fluid can increase the risk of infection in the surrounding tissue. These surgeries are generally successful in reducing the severity of most symptoms experienced by patients with TCS. In addition to observing the untethering surgery, I shadowed Dr. Flanders in the clinic and during rounds with post-operative patients. These experiences gave me invaluable insight into the compassion and communication skills required of a physician in this field, as Dr. Flanders regularly engaged with young patients and their families with both clarity and empathy. Overall, my shadowing experience at CHOP provided me with a deeper understanding of both patient care and surgical treatments. Beyond Dr. Flanders’ cases, I also observed other pediatric neurosurgeons perform procedures such as the resection of an arteriovenous malformation (A VM) of the brain, removal of an ependymoma, and treatment of a cerebral cavernous malformation (CCM). This experience as a whole not only broadened my clinical perspective but also reinforced my commitment to pursuing a career in medicine.
Olivia Bell is a guest contributor to the Princeton Medical Review. She is a junior at Princeton University pursuing a B.S.E. in Chemical and Biological Engineering with a minor in Bioengineering. Passionate about advancing healthcare through innovation, she conducts undergraduate research in the Joseph Lab, where she uses molecular simulations to model intracellular biomolecular condensates. In Winter 2024–25, she interned at the IMDEA Materials Institute, contributing to biodegradable implant research featured in a published paper, and she returned in Summer 2025 to expand her wet-lab skills. Olivia has also shadowed pediatric neurosurgeons at the Children’s Hospital of Philadelphia and volunteered weekly in the Children’s Eating Disorder Unit at Penn Medicine Princeton Health. A committed leader, she serves as President of the Princeton Biomedical Engineering Society (PBMES) and Programs Chair for the Princeton Blood Drive.
References
Governale, L. S. (2015). Craniosynostosis. Pediatric Neurology, 53(5), 394–401. doi:10.1016/j.pediatrneurol.2015.07.006
Sysoev, K. (2021). Prognosis of surgical treatment of the tethered cord syndrome in children. Journal of the Neurological Sciences, 429, 118896. doi:10.1016/j.jns.2021.118896
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