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脊柱肿瘤的导航辅助手术。

Navigation-assisted surgery for tumors of the spine.

作者信息

Bandiera S, Ghermandi R, Gasbarrini A, Barbanti Bròdano G, Colangeli S, Boriani S

机构信息

Department of Oncological and Degenerative Spine Surgery, Rizzoli Orthopedic Institute, via G.C. Pupilli 1, 40136, Bologna, Italy,

出版信息

Eur Spine J. 2013 Nov;22 Suppl 6(Suppl 6):S919-24. doi: 10.1007/s00586-013-3032-x. Epub 2013 Sep 24.

DOI:10.1007/s00586-013-3032-x
PMID:24061978
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3830048/
Abstract

PURPOSE

Computer-assisted navigation systems are largely used for pedicle screws positioning in degenerative and traumatic spine surgery. In oncologic spine surgery its use is still developing and could be extended for tumor identification and excision. Aim of this paper is to present our experience.

METHODS

Seven selected patients (5 females, 2 males), mean age 44 years (min 17-max 62) affected by primary benign or malignant tumors of the spine or spine metastases were surgically treated with the use of computer-assisted navigation system from March to October 2011.

RESULTS

At 18 months mean F.U. (min 15-max 23), no LR were observed. Revision surgery was necessary only in one case for C1 pedicle screw malpositioning.

CONCLUSIONS

Navigation system can improve surgical accuracy in screws placement and tumor localization and excision. Learning curve and technical aspects must be considered to avoid potential serious mistakes.

摘要

目的

计算机辅助导航系统在退行性和创伤性脊柱手术中广泛用于椎弓根螺钉定位。在脊柱肿瘤手术中,其应用仍在发展,并且可扩展用于肿瘤识别和切除。本文的目的是介绍我们的经验。

方法

2011年3月至10月,对7例选定患者(5例女性,2例男性)进行手术治疗,这些患者平均年龄44岁(最小17岁 - 最大62岁),患有原发性脊柱良性或恶性肿瘤或脊柱转移瘤,手术中使用了计算机辅助导航系统。

结果

平均随访18个月(最小15个月 - 最大23个月),未观察到局部复发。仅1例因C1椎弓根螺钉位置不当需要进行翻修手术。

结论

导航系统可提高螺钉置入、肿瘤定位和切除的手术准确性。必须考虑学习曲线和技术方面以避免潜在的严重错误。

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本文引用的文献

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3D-based navigation in posterior stabilisations of the cervical and thoracic spine: problems and benefits. Results of 451 screws.颈椎和胸椎后路稳定术中基于3D的导航:问题与益处。451枚螺钉的结果
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Pedicle screw placement in the thoracic spine: a randomized comparison study of computer-assisted navigation and conventional techniques.胸椎椎弓根螺钉置入:计算机辅助导航与传统技术的随机对照研究
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Morbidity of en bloc resections in the spine.整块切除术在脊柱中的发病率。
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Case report: osteoid osteoma of the C2 pedicle: surgical technique using a navigation system.病例报告:C2 椎弓根骨样骨瘤:使用导航系统的手术技术。
Clin Orthop Relat Res. 2010 Jan;468(1):283-8. doi: 10.1007/s11999-009-0958-8. Epub 2009 Jun 30.
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Navigated pedicle screw placement: experimental comparison between CT- and 3D fluoroscopy-based techniques.导航椎弓根螺钉置入:基于CT和3D透视技术的实验比较
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