Pub Date : 2024-04-01DOI: 10.3171/2024.1.FOCVID23231
Dong Hwa Heo
Recently, biportal endoscopic transforaminal lumbar interbody fusion (TLIF) has been used to treat lumbar degenerative diseases, such as lumbar instability and spondylolisthesis. Biportal endoscopic TLIF may have the advantages of endoscopic spine approaches and minimally invasive lumbar fusion surgeries. In this biportal endoscopic TLIF, large cages similar to oblique lumbar interbody fusion (OLIF) cages have been used. Biportal endoscopic TLIF using a large cage can be successfully performed in the lower lumbar area. The author presents the surgical technique of biportal endoscopic TLIF using a large cage. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23231
{"title":"Biportal endoscopic transforaminal lumbar interbody fusion using a large cage for degenerative spondylolisthesis with stenosis","authors":"Dong Hwa Heo","doi":"10.3171/2024.1.FOCVID23231","DOIUrl":"https://doi.org/10.3171/2024.1.FOCVID23231","url":null,"abstract":"Recently, biportal endoscopic transforaminal lumbar interbody fusion (TLIF) has been used to treat lumbar degenerative diseases, such as lumbar instability and spondylolisthesis. Biportal endoscopic TLIF may have the advantages of endoscopic spine approaches and minimally invasive lumbar fusion surgeries. In this biportal endoscopic TLIF, large cages similar to oblique lumbar interbody fusion (OLIF) cages have been used. Biportal endoscopic TLIF using a large cage can be successfully performed in the lower lumbar area. The author presents the surgical technique of biportal endoscopic TLIF using a large cage. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23231","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"218 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.FOCVID23196
Duncan J. Trimble, D. Sheinberg, Joseph A. Cochran
Anterior cervical foraminotomy (ACF) is an alternative surgical option for the treatment of refractory unilateral radiculopathy due to disc herniation or spondylosis. The efficacy and adverse event rate in experienced practitioners are comparable to those of anterior cervical discectomy and fusion, total disc arthroplasty, and posterior foraminotomy. However, this technique has not been widely adopted, likely because of the proximity of the working zone and the vertebral artery. The authors present a detailed operative video of a patient successfully treated with an ACF. They also present a review of the ACF literature. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23196
{"title":"Minimally invasive anterior cervical foraminotomy for unilateral radiculopathy","authors":"Duncan J. Trimble, D. Sheinberg, Joseph A. Cochran","doi":"10.3171/2024.1.FOCVID23196","DOIUrl":"https://doi.org/10.3171/2024.1.FOCVID23196","url":null,"abstract":"Anterior cervical foraminotomy (ACF) is an alternative surgical option for the treatment of refractory unilateral radiculopathy due to disc herniation or spondylosis. The efficacy and adverse event rate in experienced practitioners are comparable to those of anterior cervical discectomy and fusion, total disc arthroplasty, and posterior foraminotomy. However, this technique has not been widely adopted, likely because of the proximity of the working zone and the vertebral artery. The authors present a detailed operative video of a patient successfully treated with an ACF. They also present a review of the ACF literature. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23196","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"247 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.focvid23230
Özkan Çeliker, Yücel Doğruel
Gunshot injuries (GSIs) to the spine constitute approximately 17% to 21% of all traumatic spinal injuries, with the cervical spine being the second most frequently affected region. There is a lack of approved algorithms for patients with GSIs to the spine. Surgical intervention is controversial; however, it is generally considered in cases involving neurological deterioration with incomplete deficit, externalized liquor fistula, instability, installed toxicity, and risk of migration. Detailed information on pediatric patients is limited, primarily due to the predominance of adult patients. This study presents the full-endoscopic removal of a bullet in the C2 vertebra of a pediatric patient. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23230
{"title":"Percutaneous full-endoscopic bullet removal from the C2 vertebra in a pediatric patient","authors":"Özkan Çeliker, Yücel Doğruel","doi":"10.3171/2024.1.focvid23230","DOIUrl":"https://doi.org/10.3171/2024.1.focvid23230","url":null,"abstract":"Gunshot injuries (GSIs) to the spine constitute approximately 17% to 21% of all traumatic spinal injuries, with the cervical spine being the second most frequently affected region. There is a lack of approved algorithms for patients with GSIs to the spine. Surgical intervention is controversial; however, it is generally considered in cases involving neurological deterioration with incomplete deficit, externalized liquor fistula, instability, installed toxicity, and risk of migration. Detailed information on pediatric patients is limited, primarily due to the predominance of adult patients. This study presents the full-endoscopic removal of a bullet in the C2 vertebra of a pediatric patient. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23230","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"76 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.FOCVID23222
Vicente de Paulo Martins Coelho Junior, Joravar Dhaliwal, Vikram B. Chakravarthy
Around 40% of cancer patients present with spinal metastases (SM), the lumbar spine being the second most involved site (15%–30%) after the thoracic (60%–80%). Since the development of separation surgery, minimally invasive surgery (MIS) has increasingly been applied to approach SM, mirroring benefits yielded in the degenerative realm. Moreover, preoperative embolization potentially enhances local control for certain radioresistant histologies. Carbon fiber–reinforced PEEK hardware reduces image artifact, facilitating more accurate follow-up and radiotherapeutic planning. Additionally, short-segment cement-augmented constructs may be beneficial to decrease surgical morbidity and operative risk in this population. The authors present a lumbar spinal metastasis treated with MIS techniques. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23222
约 40% 的癌症患者会出现脊柱转移(SM),腰椎是第二大受累部位(15%-30%),仅次于胸椎(60%-80%)。自分离手术发展以来,微创手术(MIS)越来越多地被应用于脊柱转移瘤的治疗,这与退行性病变领域所取得的疗效如出一辙。此外,术前栓塞可增强对某些抗放射组织的局部控制。碳纤维加固的PEEK硬件可减少图像伪影,便于进行更准确的随访和放射治疗规划。此外,短节段水泥增强结构可能有利于降低这类人群的手术发病率和手术风险。作者介绍了用 MIS 技术治疗腰椎转移瘤的情况。视频请点击: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23222
{"title":"MIS technique for separation surgery in lumbar spine metastatic disease","authors":"Vicente de Paulo Martins Coelho Junior, Joravar Dhaliwal, Vikram B. Chakravarthy","doi":"10.3171/2024.1.FOCVID23222","DOIUrl":"https://doi.org/10.3171/2024.1.FOCVID23222","url":null,"abstract":"Around 40% of cancer patients present with spinal metastases (SM), the lumbar spine being the second most involved site (15%–30%) after the thoracic (60%–80%). Since the development of separation surgery, minimally invasive surgery (MIS) has increasingly been applied to approach SM, mirroring benefits yielded in the degenerative realm. Moreover, preoperative embolization potentially enhances local control for certain radioresistant histologies. Carbon fiber–reinforced PEEK hardware reduces image artifact, facilitating more accurate follow-up and radiotherapeutic planning. Additionally, short-segment cement-augmented constructs may be beneficial to decrease surgical morbidity and operative risk in this population. The authors present a lumbar spinal metastasis treated with MIS techniques. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23222","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"267 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ganglioneuroma (GN) is a rare solid neoplasm developing from neural crest cells of sympathetic ganglia or adrenal medulla. It usually presents as an asymptomatic mass in the retroperitoneal space and mediastinum. Resection through open surgery or minimal access is recommended. The video illustrates the case of a 23-year-old female with an incidental finding of thoracic GN. The authors performed a combined, staged approach to ensure complete resection, which involved unilateral T3–4 biportal endoscopy (UBE) for rhizotomy and nerve root decompression, followed by video-assisted thoracoscopic surgery (VATS) for complete excision. The procedure was uneventful, with full recovery and no postoperative complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.2.FOCVID23210
{"title":"Combined unilateral biportal endoscopy and video-assisted thoracoscopic surgery for complete excision of a T3–T4 right ganglioneuroma","authors":"Enrico Giordan, Changik Lee, Dimas Rahman Setiawan, Phattareeya Pholprajug, Jin-Sung Kim","doi":"10.3171/2024.2.focvid23210","DOIUrl":"https://doi.org/10.3171/2024.2.focvid23210","url":null,"abstract":"Ganglioneuroma (GN) is a rare solid neoplasm developing from neural crest cells of sympathetic ganglia or adrenal medulla. It usually presents as an asymptomatic mass in the retroperitoneal space and mediastinum. Resection through open surgery or minimal access is recommended. The video illustrates the case of a 23-year-old female with an incidental finding of thoracic GN. The authors performed a combined, staged approach to ensure complete resection, which involved unilateral T3–4 biportal endoscopy (UBE) for rhizotomy and nerve root decompression, followed by video-assisted thoracoscopic surgery (VATS) for complete excision. The procedure was uneventful, with full recovery and no postoperative complications. The video can be found here: https://stream.cadmore.media/r10.3171/2024.2.FOCVID23210","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"552 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01DOI: 10.3171/2024.1.FOCVID23208
Jannik Leyendecker, Nelson Sofoluke, C. P. Hofstetter, Sanjay Konakondla
Synovial spinal cysts cause radiculopathy and back pain, with rare reports of cauda equina syndrome. Hypermobility and instability are cornerstones for synovial cyst formation. The incidence is around 5%, and data for bilateral cysts are lacking. Surgery is indicated after conservative measures fail. Recurrence is common and is potentially due to joint violation and destabilization from open surgery. This could be prevented via ultra-minimally invasive approaches. The authors present full endoscopic removal of bilateral synovial cysts in a patient with grade 1 stable spondylolisthesis and include a 360° view for confirmation of complete decompression. Postoperatively, the patient reported immediate pain relief. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23208
{"title":"Full endoscopic resection of large bilateral synovial cysts in lumbar spine","authors":"Jannik Leyendecker, Nelson Sofoluke, C. P. Hofstetter, Sanjay Konakondla","doi":"10.3171/2024.1.FOCVID23208","DOIUrl":"https://doi.org/10.3171/2024.1.FOCVID23208","url":null,"abstract":"Synovial spinal cysts cause radiculopathy and back pain, with rare reports of cauda equina syndrome. Hypermobility and instability are cornerstones for synovial cyst formation. The incidence is around 5%, and data for bilateral cysts are lacking. Surgery is indicated after conservative measures fail. Recurrence is common and is potentially due to joint violation and destabilization from open surgery. This could be prevented via ultra-minimally invasive approaches. The authors present full endoscopic removal of bilateral synovial cysts in a patient with grade 1 stable spondylolisthesis and include a 360° view for confirmation of complete decompression. Postoperatively, the patient reported immediate pain relief. The video can be found here: https://stream.cadmore.media/r10.3171/2024.1.FOCVID23208","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"111 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23116
Miguel Sáez-Alegre, Christian I. Rios-Vicil, Keaton Piper, Edinson Najera, Walter C Jean
Keyhole approaches, performed with the endoscope, microscope, or exoscope, aim to minimize tissue traumatization while maximizing surgical view. The exoscope can provide better ergonomics than the microscope without restricting the space inside of the keyhole, as when using the endoscope. However, a frequently quoted reason for intraoperative exoscope-to-microscope conversion is the absence of sufficient light. In this video, the authors present 4 patients who underwent posterior fossa keyhole surgery without intraoperative conversion. The surgical objective was achieved in all patients without associated morbidity. After adequate adaptation, the exoscope allows sufficient light in the surgical field to perform safe keyhole surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23116
{"title":"Feasibility of exoscopic keyhole surgery: case series","authors":"Miguel Sáez-Alegre, Christian I. Rios-Vicil, Keaton Piper, Edinson Najera, Walter C Jean","doi":"10.3171/2023.10.focvid23116","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23116","url":null,"abstract":"Keyhole approaches, performed with the endoscope, microscope, or exoscope, aim to minimize tissue traumatization while maximizing surgical view. The exoscope can provide better ergonomics than the microscope without restricting the space inside of the keyhole, as when using the endoscope. However, a frequently quoted reason for intraoperative exoscope-to-microscope conversion is the absence of sufficient light. In this video, the authors present 4 patients who underwent posterior fossa keyhole surgery without intraoperative conversion. The surgical objective was achieved in all patients without associated morbidity. After adequate adaptation, the exoscope allows sufficient light in the surgical field to perform safe keyhole surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23116","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139126756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23118
A. M. Auricchio, Francesco Calvanese, M. Lehecka
Extradural anterior clinoidectomy is a resourceful technique to decompress the optic nerve as well as increase exposure of the parasellar region during extensive approaches. Despite requiring adjunctive epidural bone work, this technique allows safe optic nerve mobilization and early devascularization for anterior clinoidal meningioma resection. This 2D operative video describes right optic nerve decompression by extradural anterior clinoidectomy and subsequent resection of a right Al-Mefty type III clinoid meningioma under exoscope magnification. The patient was a 50-year-old woman with a 1-year history of right visual acuity impairment and papillary atrophy. The exoscope allows a 360° view around the anterior clinoid, improving maneuverability. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23118
{"title":"Exoscopic extradural anterior clinoidectomy","authors":"A. M. Auricchio, Francesco Calvanese, M. Lehecka","doi":"10.3171/2023.10.focvid23118","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23118","url":null,"abstract":"Extradural anterior clinoidectomy is a resourceful technique to decompress the optic nerve as well as increase exposure of the parasellar region during extensive approaches. Despite requiring adjunctive epidural bone work, this technique allows safe optic nerve mobilization and early devascularization for anterior clinoidal meningioma resection. This 2D operative video describes right optic nerve decompression by extradural anterior clinoidectomy and subsequent resection of a right Al-Mefty type III clinoid meningioma under exoscope magnification. The patient was a 50-year-old woman with a 1-year history of right visual acuity impairment and papillary atrophy. The exoscope allows a 360° view around the anterior clinoid, improving maneuverability. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23118","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"32 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23157
Grant Arzumanov, Seung W. Jeong, Bhavika Gupta, Rocco Dabecco, Jose Sandoval, Richard Williamson, Alexander Yu
Superior hypophyseal artery (SHA) aneurysms are rare paraclinoid aneurysms with a mortality rate as high as 3%–6%. Surgical clipping of these aneurysms is technically challenging due to the surrounding anatomy. The large size and complicated surrounding anatomy make endovascular coiling very difficult. Here we present the case of a ruptured right SHA aneurysm. The authors present technical nuances of the clipping using an exoscope rather than a traditional microscope. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23157
{"title":"Frontotemporal craniotomy with orbital osteotomy for superior hypophyseal artery aneurysm clipping","authors":"Grant Arzumanov, Seung W. Jeong, Bhavika Gupta, Rocco Dabecco, Jose Sandoval, Richard Williamson, Alexander Yu","doi":"10.3171/2023.10.focvid23157","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23157","url":null,"abstract":"Superior hypophyseal artery (SHA) aneurysms are rare paraclinoid aneurysms with a mortality rate as high as 3%–6%. Surgical clipping of these aneurysms is technically challenging due to the surrounding anatomy. The large size and complicated surrounding anatomy make endovascular coiling very difficult. Here we present the case of a ruptured right SHA aneurysm. The authors present technical nuances of the clipping using an exoscope rather than a traditional microscope. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23157","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"23 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.3171/2023.10.focvid23155
A. Mallela, Tritan J. Plute, Hussam Abou-Al-Shaar, David T. Fernandes Cabral, Constantinos G. Hadjipanayis
The supracerebellar infratentorial (SCIT) approach is a well-described corridor to lesions in the quadrigeminal cistern, pineal gland, and dorsal midbrain. It can be performed in the prone or sitting position. The sitting position offers the benefit of gravity retraction of the cerebellum but comes at the expense of nonergonomic hand positioning and the potential risk of air embolism. The 3D exoscope is an alternative to the operating microscope and permits the SCIT approach in the prone position with excellent visualization. This video demonstrates exoscope-based SCIT approach for resection of a pineal meningioma in the prone position. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23155
{"title":"Exoscope-based supracerebellar infratentorial approach for a pineal meningioma in the prone position","authors":"A. Mallela, Tritan J. Plute, Hussam Abou-Al-Shaar, David T. Fernandes Cabral, Constantinos G. Hadjipanayis","doi":"10.3171/2023.10.focvid23155","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23155","url":null,"abstract":"The supracerebellar infratentorial (SCIT) approach is a well-described corridor to lesions in the quadrigeminal cistern, pineal gland, and dorsal midbrain. It can be performed in the prone or sitting position. The sitting position offers the benefit of gravity retraction of the cerebellum but comes at the expense of nonergonomic hand positioning and the potential risk of air embolism. The 3D exoscope is an alternative to the operating microscope and permits the SCIT approach in the prone position with excellent visualization. This video demonstrates exoscope-based SCIT approach for resection of a pineal meningioma in the prone position. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23155","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"55 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}