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2016, Volume 7, Number 2, Page(s) 097-110
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Intraoperative Imaging and Navigation for Minimally Invasive Spinal Tumor Surgery: Case Series and Literature Review
Ki-Eun Chang, Martin H. Pham, Patrick C. Hsieh
Department of Neurological Surgery, University of Southern California, Keck School of Medicine, Los Angeles, California
Keywords: Isocentric C-arm, minimally-invasive, navigation, O-arm, stealth, spine tumor
Abstract
INTRODUCTION: The prognosis for spinal tumors depends on the extent of resection and time to adjuvant therapy. Minimally invasive surgery (MIS) helps to accomplish these goals with fewer complications, and intraoperative navigation may improve the degree of resection and guide accurate placement of instrumentation. The authors aimed to analyze the utility of 3-D navigation for minimally-invasive spinal tumor surgery through a case series and literature review.

METHODS: Current literature was reviewed to identify studies utilizing MIS with intraoperative navigation for the treatment of spinal tumors. The medical records and imaging studies for 4 cases from the authors' experience were analyzed in conjunction.

RESULT: Four patients were included in our case series with an average age of 53.8yrs. Pathology included 3 metastatic tumors and 1 chordoma. Gross total resection was achieved in 3 of the 4 cases with no evidence of recurrence noted at each respective follow-up. A literature search revealed 3 studies that incorporated navigation assisted MIS for treating spinal tumors.

CONCLUSION: Image-guided navigation can serve as a useful adjunct to MIS by improving the accuracy of instrumentation and enhancing the ability to obtain gross-total resection. Further clinical trials are warranted to demonstrate its benefits in a systematic manner.

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