Open fetal myelomeningocele repair with closure of a moderate-sized defect

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.