Department of Orthopedic Surgery, Yodogawa Christian Hospital, 2-9-26 Awaji, Higashiyodogawa-Ku, Osaka 533-0021, Japan.
Clin Orthop Relat Res. 2012 Jan;470(1):275-83. doi: 10.1007/s11999-011-2094-5. Epub 2011 Oct 19.
The navigation system was introduced to orthopaedic surgery in the 1990s. More recently, CT-based navigation systems have been used more commonly in spine and joint replacement surgery because of their precision.
QUESTIONS/PURPOSES: The aim of our study was to evaluate the accuracy and efficacy of navigation-assisted excision of bone and soft tissue tumors.
From 2006 to 2009, we performed navigation-assisted surgery in 16 patients, 11 males and five females, with a mean age of 39 years (range, 13-70 years). We diagnosed nine benign bone tumors and seven malignant bone and soft tissue tumors. In two patients, the malignant soft tissue tumors infiltrated the adjacent bones. Nine excisional biopsies for benign tumors and seven en bloc excisions for malignant tumors were performed. In all cases, the point registration method was performed using 10 skin markers, which were placed around the tumor. Each excisional difference between the preoperative and postoperative plans was evaluated histologically or by postoperative CT.
The mean accuracy of this system, which was determined using skin markers, was 0.93 mm (range, 0.6-1.2 mm). All biopsy and excision samples were evaluated by pathologic examination and postoperative CT imaging. The mean difference between the planned margin and postoperative CT or excised histologic specimen was 0 mm to 4 mm. The mean followup was 34 months (range, 10-54 months). There were no local recurrences, except for excision of skip metastases in a patient with a chordoma.
We report our experience with navigation-assisted surgery for bone and soft tissue tumors. Navigation-assisted surgery could be indicated for sufficiently reliable, accurate, and minimally invasive resections.
导航系统于 20 世纪 90 年代引入矫形外科。由于其精度较高，近年来基于 CT 的导航系统在脊柱和关节置换手术中更为常用。
问题/目的：我们研究的目的是评估导航辅助切除骨和软组织肿瘤的准确性和疗效。
从 2006 年到 2009 年，我们对 16 例患者（男性 11 例，女性 5 例，平均年龄 39 岁[范围，13-70 岁]）进行了导航辅助手术。我们诊断了 9 例良性骨肿瘤和 7 例恶性骨和软组织肿瘤。在 2 例患者中，恶性软组织肿瘤浸润了相邻的骨骼。对 9 例良性肿瘤进行了切除活检，对 7 例恶性肿瘤进行了整块切除。在所有病例中，均采用 10 个皮肤标记物进行点注册方法，这些标记物放置在肿瘤周围。通过组织学或术后 CT 评估术前和术后计划之间的每个切除差异。
该系统的平均精度（使用皮肤标记物确定）为 0.93 毫米（范围，0.6-1.2 毫米）。所有活检和切除标本均通过病理检查和术后 CT 成像进行评估。计划边界与术后 CT 或切除组织学标本之间的平均差异为 0 毫米至 4 毫米。平均随访时间为 34 个月（范围，10-54 个月）。除 1 例脊索瘤患者切除跳跃转移外，无局部复发。
我们报告了我们在骨和软组织肿瘤导航辅助手术方面的经验。导航辅助手术可用于足够可靠、准确和微创的切除。
