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Minimally invasive prone transpsoas lateral lumbar interbody fusion using navigation. 导航微创俯卧经腰肌外侧腰椎椎体间融合术。
Neurosurgical focus: Video Pub Date : 2026-07-01 DOI: 10.3171/2026.4.FOCVID2639
Shailen G Sampath, Alex Hernandez Manriquez, Andrew S Zhang, Nathan J Winans, Vivian P Le, Dean Chou, Paul Park, Andrew K Chan
{"title":"Minimally invasive prone transpsoas lateral lumbar interbody fusion using navigation.","authors":"Shailen G Sampath, Alex Hernandez Manriquez, Andrew S Zhang, Nathan J Winans, Vivian P Le, Dean Chou, Paul Park, Andrew K Chan","doi":"10.3171/2026.4.FOCVID2639","DOIUrl":"10.3171/2026.4.FOCVID2639","url":null,"abstract":"<p><p>Minimally invasive spine surgery continues to evolve, with the single-position prone transpsoas lateral approach offering simultaneous lateral and posterior access without repositioning. This technique minimizes tissue disruption while enabling efficient single-position surgery. The authors present the case of a 57-year-old male with left-sided back pain and radiculopathy recalcitrant to conservative treatment. MRI revealed multilevel degeneration, with single photon emission CT (SPECT) highlighting L2-3 pathology. After exhausting conservative measures, he underwent a minimally invasive prone lateral lumbar interbody fusion at L2-3 with the use of navigation. This video highlights the technical steps and advantages of this approach and navigated technique. The video can be found here: https://stream.cadmore.media/r10.3171/2026.4.FOCVID2639.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"15 1","pages":"V5"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Navigation-assisted prone lateral transpsoas interbody fusion to potentially avoid approach-related complications. 导航辅助俯卧外侧转腰椎间盘椎间融合术可潜在避免入路相关并发症。
Neurosurgical focus: Video Pub Date : 2026-07-01 DOI: 10.3171/2026.4.FOCVID2651
Camila A Moreno Mesa, Steve S Cho, Juan P Giraldo, Juan S Uribe
{"title":"Navigation-assisted prone lateral transpsoas interbody fusion to potentially avoid approach-related complications.","authors":"Camila A Moreno Mesa, Steve S Cho, Juan P Giraldo, Juan S Uribe","doi":"10.3171/2026.4.FOCVID2651","DOIUrl":"10.3171/2026.4.FOCVID2651","url":null,"abstract":"<p><p>This video demonstrates CT-based navigated single-position lateral transpsoas interbody fusion with posterior percutaneous instrumentation. Intraoperative 3D navigation is integrated throughout the procedure to optimize trajectory planning, corridor docking, and implant placement. Navigated lateral surgery enables real-time visualization of the psoas and anterior vascular structures, helping mitigate neurovascular injury and anterior visceral complications during transpsoas access. By enhancing anatomical precision and reducing reliance on fluoroscopy, navigation may improve safety, streamline workflow, and further advance minimally invasive lateral fusion techniques. The video can be found here: https://stream.cadmore.media/r10.3171/2026.4.FOCVID2651.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"15 1","pages":"V9"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intrauterine hematoma evacuation during fetoscopic myelomeningocele repair: a novel application of the NICO Myriad. 胎儿镜下脊髓脊膜膨出修复术中的宫内血肿清除：NICO Myriad的新应用。
Neurosurgical focus: Video Pub Date : 2026-04-01 DOI: 10.3171/2026.1.FOCVID25233
Raj Swaroop Lavadi, Michael C Sundahl, Kyle Ortiz Rodriguez, Brittany J Arkerson, Anas Aljabari, Laurie L Ackerman, Rabia Qaiser, Jignesh Tailor, Thomas Larrew, Charles B Stevenson, Ramen H Chmait, Hiba J Mustafa, Jason Chu
{"title":"Intrauterine hematoma evacuation during fetoscopic myelomeningocele repair: a novel application of the NICO Myriad.","authors":"Raj Swaroop Lavadi, Michael C Sundahl, Kyle Ortiz Rodriguez, Brittany J Arkerson, Anas Aljabari, Laurie L Ackerman, Rabia Qaiser, Jignesh Tailor, Thomas Larrew, Charles B Stevenson, Ramen H Chmait, Hiba J Mustafa, Jason Chu","doi":"10.3171/2026.1.FOCVID25233","DOIUrl":"10.3171/2026.1.FOCVID25233","url":null,"abstract":"<p><p>Evacuating intrauterine hematomas during fetoscopic myelomeningocele repair can be challenging. The NICO Myriad (Stryker Inc.) has been previously described to resect brain tumors, as an adjunct in intraventricular neuroendoscopy, and, most recently, has been proven to effectively remove intracerebral hematomas at clinical and cost-effective significance. This device has not been described in fetal neurosurgery. In this video, the NICO Myriad was utilized during a minilaparotomy fetal myelomeningocele repair to mechanically aspirate an intrauterine hematoma noted at the end of the operation. The surgical technique and technical nuances of using the NICO Myriad during fetoscopic myelomeningocele repair are reviewed. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25233.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 2","pages":"V10"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hybrid approach to closure in fetoscopic myelomeningocele repair. 胎儿镜下脊髓脊膜膨出修补术中闭合的混合入路。
Neurosurgical focus: Video Pub Date : 2026-04-01 DOI: 10.3171/2026.1.FOCVID25222
Natasha Hongsermeier-Graves, Vance R Mortimer, Stephen J Fenton, Martha A Monson, Robert J Bollo
{"title":"Hybrid approach to closure in fetoscopic myelomeningocele repair.","authors":"Natasha Hongsermeier-Graves, Vance R Mortimer, Stephen J Fenton, Martha A Monson, Robert J Bollo","doi":"10.3171/2026.1.FOCVID25222","DOIUrl":"10.3171/2026.1.FOCVID25222","url":null,"abstract":"<p><p>Neural tube defects (NTDs) affect 2 in 1000 births worldwide. Myelomeningocele (MMC) represents a severe NTD, often with permanent neurological sequelae. The randomized multicenter Management of Myelomeningocele Study (MOMS) showed that open prenatal (compared to postnatal) myelomeningocele closure could reverse hindbrain herniation, lower rates of shunt insertion for hydrocephalus, and improve neurological function, with the trade-off of increased maternal complications and premature birth. Fetoscopic approaches may have equivalent benefits to open fetal MMC closure with fewer maternal complications. The hybrid approach to fetoscopic repair (primary closure vs biosubstitute patch) described in this video can be tailored to individual fetal anatomy and promote comparable epithelialization over time. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25222.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 2","pages":"V9"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Open fetal myeloschisis closure: pearls for uterine exposure and closure. 开放胎儿髓裂闭合：珍珠用于子宫暴露和闭合。
Neurosurgical focus: Video Pub Date : 2026-04-01 DOI: 10.3171/2026.1.FOCVID25231
David S Hersh, Andrew J Healy, Timothy M Crombleholme
{"title":"Open fetal myeloschisis closure: pearls for uterine exposure and closure.","authors":"David S Hersh, Andrew J Healy, Timothy M Crombleholme","doi":"10.3171/2026.1.FOCVID25231","DOIUrl":"10.3171/2026.1.FOCVID25231","url":null,"abstract":"<p><p>Fetal closure of an open neural tube defect offers the potential to limit progressive neurological injury and improve long-term outcomes. Myeloschisis presents unique challenges due to the technical complexity of mobilizing the skin and achieving adequate soft tissue coverage, particularly in the sacral region. In this video, the authors demonstrate an open fetal myeloschisis closure in a fetus with an S1-level defect and associated grade 3 hindbrain herniation. The preoperative counseling process, surgical technique, and perioperative course are highlighted, with a focus on pearls for the exposure and closure of the uterus. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25231.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 2","pages":"V4"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Open fetal myelomeningocele repair with closure of a moderate-sized defect. 打开胎儿髓脊膜膨出修复与关闭一个中等大小的缺陷。
Neurosurgical focus: Video Pub Date : 2026-04-01 DOI: 10.3171/2026.1.FOCVID25224
Natalie Amaral-Nieves, Belinda Shao, Julie Monteagudo, Debra Watson-Smith, Petra Klinge, Francois I Luks, Konstantina Svokos
{"title":"Open fetal myelomeningocele repair with closure of a moderate-sized defect.","authors":"Natalie Amaral-Nieves, Belinda Shao, Julie Monteagudo, Debra Watson-Smith, Petra Klinge, Francois I Luks, Konstantina Svokos","doi":"10.3171/2026.1.FOCVID25224","DOIUrl":"10.3171/2026.1.FOCVID25224","url":null,"abstract":"<p><p>The authors present a case of open fetal myelomeningocele repair for a lumbosacral defect diagnosed at 19 weeks with ventriculomegaly and Chiari type II malformation. After multidisciplinary evaluation, the patient met MOMS (Management of Myelomeningocele Study)-based criteria and underwent fetal repair with placode dissection, dural and myofascial reconstruction, and AlloDerm-assisted skin closure. The postoperative course was stable, and premature rupture of membranes led to cesarean delivery at 35 weeks 4 days. The infant demonstrated spontaneous lower extremity movement and stable ventriculomegaly. At 10 months, he developed a dermoid cyst and tethered cord requiring surgery with good recovery. This case highlights the benefits and evolving long-term considerations of prenatal repair. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25224.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 2","pages":"V3"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fetoscopic myelomeningocele repair: standard technique and approaches for closure of large defects. 胎儿镜下脊髓脊膜膨出修复：大缺损闭合的标准技术和方法。
Neurosurgical focus: Video Pub Date : 2026-04-01 DOI: 10.3171/2026.1.FOCVID25226
Arjun R Adapa, Anthony J Tang, Nicholas Schmoke, Lynn Simpson, Russell Miller, Laurence Ring, Vincent P Duron, Neil A Feldstein
{"title":"Fetoscopic myelomeningocele repair: standard technique and approaches for closure of large defects.","authors":"Arjun R Adapa, Anthony J Tang, Nicholas Schmoke, Lynn Simpson, Russell Miller, Laurence Ring, Vincent P Duron, Neil A Feldstein","doi":"10.3171/2026.1.FOCVID25226","DOIUrl":"10.3171/2026.1.FOCVID25226","url":null,"abstract":"<p><p>Fetoscopic repair of myelomeningocele (MMC) offers a minimally invasive alternative to open prenatal surgery. This approach protects exposed neural tissue while reducing the need for postnatal CSF diversion and lowering maternal morbidity compared to open techniques. In this video, the authors demonstrate a standardized fetoscopic technique for MMC repair using an externalized uterine approach. Key steps include placode release, excision of transitional epithelium, and multilayer closure with a dural substitute. The authors highlight technical pearls for managing myeloschisis and large MMCs, including relaxing incisions and myofascial mobilization, to achieve a tension-free, watertight repair. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25226.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 2","pages":"V6"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Minilaparotomy-assisted approach for fetoscopic myelomeningocele closure. 微创开腹辅助入路治疗胎儿镜下脊髓脊膜膨出。
Neurosurgical focus: Video Pub Date : 2026-04-01 DOI: 10.3171/2026.1.FOCVID25234
Katherine Holste, Scott Shainker, Farokh Demehri, Eyal Krispin, Alireza Shamshirsaz, Weston Northam
{"title":"Minilaparotomy-assisted approach for fetoscopic myelomeningocele closure.","authors":"Katherine Holste, Scott Shainker, Farokh Demehri, Eyal Krispin, Alireza Shamshirsaz, Weston Northam","doi":"10.3171/2026.1.FOCVID25234","DOIUrl":"10.3171/2026.1.FOCVID25234","url":null,"abstract":"<p><p>Fetal closure has demonstrated a reduction in need for ventricular shunting, reversal of hindbrain herniation, and improved mobility compared to postnatal closure. Open fetal closure can benefit the fetus, but also places the mother at risk of obstetrical complications. Fetoscopic repair allows for prenatal closure of the myelomeningocele defect, while avoiding the open hysterotomy and providing the option for vaginal delivery in some cases. There are multiple techniques for performing fetoscopic repair; each has its benefits and detriments. Here a technique is presented for a minilaparotomy-assisted approach for fetoscopic myelomeningocele closure. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25234.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 2","pages":"V7"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cellular Therapy for In Utero Repair of Myelomeningocele (the CuRe trial): neurosurgical repair video. 子宫内修复脊髓脊膜膨出的细胞疗法（CuRe试验）：神经外科修复视频。
Neurosurgical focus: Video Pub Date : 2026-04-01 DOI: 10.3171/2026.1.FOCVID25229
Elizabeth Reynolds, Payam Saadai, Cameron Sadegh, Amelia S McLennan, Erin G Brown, Jamie E Anderson, Priyadarsini Kumar, Aijun Wang, Diana L Farmer, Marike Zwienenberg
{"title":"Cellular Therapy for In Utero Repair of Myelomeningocele (the CuRe trial): neurosurgical repair video.","authors":"Elizabeth Reynolds, Payam Saadai, Cameron Sadegh, Amelia S McLennan, Erin G Brown, Jamie E Anderson, Priyadarsini Kumar, Aijun Wang, Diana L Farmer, Marike Zwienenberg","doi":"10.3171/2026.1.FOCVID25229","DOIUrl":"10.3171/2026.1.FOCVID25229","url":null,"abstract":"<p><p>The Management of Myelomeningocele Study (MOMS) established that prenatal repair of myelomeningocele (MMC) improved the rate of ventriculoperitoneal shunt insertion for the treatment of hydrocephalus, compared to postnatal repair. While there was mild improvement of motor function, most children were unable to ambulate independently. Therefore, the ongoing phase 1/2a clinical trial Cellular Therapy for In Utero Repair of Myelomeningocele (CuRe trial) aims to further improve distal neurological function using placenta-derived mesenchymal stem/stromal cells seeded on an extracellular matrix (PMSC-ECM) to augment open fetal repair of MMC. Here, the authors present a video of the neurosurgical repair using the PMSC-ECM. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25229.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 2","pages":"V11"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fetoscopic repair of myeloschisis: optimizing the three-layer closure. 胎镜下修复髓裂：优化三层缝合。
Neurosurgical focus: Video Pub Date : 2026-04-01 DOI: 10.3171/2026.1.FOCVID25217
Matthieu D Weber, Ryan B Juncker, Eric A Sribnick, Karen A Diefenbach, Adolfo Etchegaray, Jeffrey R Leonard, Oluseyi K Ogunleye, Jonathan A Pindrik, Oluyinka O Olutoye, Albert M Isaacs
{"title":"Fetoscopic repair of myeloschisis: optimizing the three-layer closure.","authors":"Matthieu D Weber, Ryan B Juncker, Eric A Sribnick, Karen A Diefenbach, Adolfo Etchegaray, Jeffrey R Leonard, Oluseyi K Ogunleye, Jonathan A Pindrik, Oluyinka O Olutoye, Albert M Isaacs","doi":"10.3171/2026.1.FOCVID25217","DOIUrl":"10.3171/2026.1.FOCVID25217","url":null,"abstract":"<p><p>A 25-year-old female presented at 24 weeks and 2 days of gestation with suspected myeloschisis on fetal anatomical survey. Imaging demonstrated an L4-S4 defect, ventriculomegaly, and Chiari type II malformation. Closure remains one of the least standardized components of fetoscopic repair, although small studies have suggested that three-layer repair may reduce CSF leakage, shorten maternal hospitalization, decrease revision rates, and improve Chiari malformation outcomes. The patient underwent a three-port fetoscopic repair with three-layer closure. The authors showcase their approach and advocate for closure technique standardization and its correlation with long-term neurological outcomes in the post-Management of Myelomeningocele Study (MOMS) trial era. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25217.</p>","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 2","pages":"V8"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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