{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:03:52Z","timestamp":1782864232307,"version":"3.54.5"},"reference-count":20,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats: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.<\/jats:p>\n                  <jats:p>\n                    The video can be found here:\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/stream.cadmore.media\/r10.3171\/2026.1.FOCVID25231\">https:\/\/stream.cadmore.media\/r10.3171\/2026.1.FOCVID25231<\/jats:ext-link>\n                  <\/jats:p>","DOI":"10.3171\/2026.1.focvid25231","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T02:27:28Z","timestamp":1775010448000},"page":"V4","source":"Crossref","is-referenced-by-count":0,"title":["Open fetal myeloschisis closure: pearls for uterine exposure and closure"],"prefix":"10.3171","volume":"14","author":[{"given":"David S.","family":"Hersh","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Connecticut Children\u2019s, Hartford;"},{"name":"Department of Neurosurgery, UConn School of Medicine, Farmington;"},{"name":"Department of Pediatrics, UConn School of Medicine, Farmington;"},{"name":"Connecticut Children\u2019s Fetal Care Center, Connecticut Children\u2019s, Hartford; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Healy","sequence":"additional","affiliation":[{"name":"Connecticut Children\u2019s Fetal Care Center, Connecticut Children\u2019s, Hartford; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy M.","family":"Crombleholme","sequence":"additional","affiliation":[{"name":"Connecticut Children\u2019s Fetal Care Center, Connecticut Children\u2019s, Hartford; and"},{"name":"Division of Pediatric General, Thoracic, and Fetal Surgery, Connecticut Children\u2019s, Hartford, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"AJR Am J Roentgenol","first-page":"1376","article-title":"Myelomeningocele versus myelocele on fetal MR images: are there differences in brain findings?","volume":"211","author":"Nagaraj UD","year":"2018","unstructured":"Nagaraj UD, Bierbrauer KS, Stevenson CB,  Myelomeningocele versus myelocele on fetal MR images: are there differences in brain findings? AJR Am J Roentgenol. 2018;211(6):1376\u20131380. doi:10.2214\/AJR.18.20088"},{"issue":"2","key":"b2","series-title":"Fetal Diagn Ther","first-page":"1","article-title":"Differences between myeloschisis and myelomeningocele in patients undergoing prenatal repair of open spina bifida","volume":"52","author":"M\u00fcller JM","year":"2025","unstructured":"M\u00fcller JM, Corral Sere\u00f1o E, Jimenez A,  Differences between myeloschisis and myelomeningocele in patients undergoing prenatal repair of open spina bifida. Fetal Diagn Ther. 2025;52(2):1\u201310. doi:10.1159\/000538099"},{"issue":"6","key":"b3","series-title":"J Neurosurg Pediatr","first-page":"640","article-title":"Prenatal counseling for myelomeningocele in the era of fetal surgery: a shared decision-making approach","volume":"25","author":"Ravindra VM","year":"2020","unstructured":"Ravindra VM, Aldave G, Weiner HL,  Prenatal counseling for myelomeningocele in the era of fetal surgery: a shared decision-making approach. 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J Neurosurg Pediatr. 2025;35(1):10\u201321. doi:10.3171\/2024.7.PEDS24200"},{"issue":"8","key":"b6","series-title":"Paediatr Anaesth","first-page":"748","article-title":"Supplementing desflurane with intravenous anesthesia reduces fetal cardiac dysfunction during open fetal surgery","volume":"20","author":"Boat A","year":"2010","unstructured":"Boat A, Mahmoud M, Michelfelder EC,  Supplementing desflurane with intravenous anesthesia reduces fetal cardiac dysfunction during open fetal surgery. Paediatr Anaesth. 2010;20(8):748\u2013756. doi:10.1111\/j.1460-9592.2010.03350.x"},{"issue":"2","key":"b7","series-title":"Oper Neurosurg","first-page":"158","article-title":"Improved postoperative metrics with modified myofascial closure in fetal myelomeningocele repair","volume":"18","author":"Flanders TM","year":"2020","unstructured":"Flanders TM, Madsen PJ, Pisapia JM,  Improved postoperative metrics with modified myofascial closure in fetal myelomeningocele repair. 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