Goodman Campbell Brain and Spine, Indiana University Department of Neurological Surgery, Indianapolis, Indiana 46202, USA.
Neurosurgery. 2012 Jun;70(2 Suppl Operative):177-80. doi: 10.1227/NEU.0b013e3182309448.
We describe the use of an intraoperative CT scan obtained using the Medtronic O-arm (Littleton, Massachusetts) for image-guided cannulation of the foramen ovale not previously accessible with the use of fluoroscopy alone. Unlike previously described procedures, this technique does not require placement of an invasive head clamp and may be used with an awake patient.
To describe the use of intraoperative neuronavigation for accessing skull base foramina and, specifically, cannulating of the foramen ovale during percutaneous rhizotomy procedures using an intraoperative image guidance CT scanner (Medtronic O-arm, Littleton, Massachusetts).
A noninvasive Landmark Fess Strap attached to a spine reference frame was applied to the heads of 4 patients who harbored a difficult-to-access foramen ovale. An intraoperative HD3D skull base scan using a Medtronic O-arm was obtained, and Synergy Spine software was used to create 3D reconstructions of the skull base. Using image guidance, we navigated the needle to percutaneously access the foramen ovale by the use of a single tract for successful completion of balloon compression of the trigeminal nerve.
All 4 patients (3 females and 1 male; ages 65-75) underwent the procedure with no complications.
Based on our experience, neuronavigation with the use of intraoperative O-arm CT imaging is useful during these cases.
我们描述了使用 Medtronic O-arm（马萨诸塞州利特尔顿）进行术中 CT 扫描，以引导单独使用透视无法触及的卵圆孔进行插管。与之前描述的方法不同，该技术不需要放置侵入性头夹，并且可以在清醒患者中使用。
描述使用术中神经导航来访问颅底孔，特别是在使用术中图像引导 CT 扫描仪（Medtronic O-arm，马萨诸塞州利特尔顿）进行经皮神经根切断术时对卵圆孔进行插管。
将非侵入性的 Landmark Fess 颈带附在脊柱参考框架上，应用于 4 例具有难以触及的卵圆孔的患者头部。使用 Medtronic O-arm 进行术中 HD3D 颅底扫描，并使用 Synergy Spine 软件创建颅底的 3D 重建。使用图像引导，我们导航针通过单个通道经皮进入卵圆孔，成功完成了对三叉神经的球囊压迫。
所有 4 名患者（3 名女性和 1 名男性；年龄 65-75 岁）均无并发症地完成了该手术。
根据我们的经验，在这些情况下，使用术中 O-arm CT 成像进行神经导航是有用的。
