Kadhim Muayad, Binitie Odion, O'Toole Patrick, Grigoriou Emmanouil, De Mattos Camila B, Dormans John P
Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
J Pediatr Orthop B. 2017 Jul;26(4):362-369. doi: 10.1097/BPB.0000000000000406.
Intraoperative radiographic guidance has traditionally been utilized in orthopedic surgery through 2-D navigation with the C-arm and recently with 3-D navigation with the O-arm. The aim of this study was to describe the outcome of surgical treatment of spinal osteoblastoma and osteoid osteoma with the utilization of the O-arm and conventional C-arm guidance. This is a retrospective cohort study of patients with spinal osteoid osteoma and or osteoblastoma who were treated at our institution between 2002 and 2011. Seventeen patients were examined in this study including seven with spinal osteoblastoma and 10 with spinal osteoid osteoma. The mean age of the patients at surgery was 11.5±3.9 years. The O-arm was used in seven patients and the C-arm in 10 patients. The C-arm failed to identify the tumor in one case and needed transport to perform a computed tomographic-scan. The length of surgery was shorter when the O-arm was used, especially in the osteoblastoma group. Thirteen patients were pain free at the last follow-up visit and two patients developed recurrence. Radiographs at the last follow-up did not show signs of vertebral instability following tumor resection. Safe and effective localization of spine tumors and confirmation of tumor removal during surgery was achieved by intraoperative radiographic guidance specifically with the O-arm 3-D navigation system.
III.
传统上，骨科手术中通过C形臂二维导航以及最近通过O形臂三维导航来使用术中放射学引导。本研究的目的是描述利用O形臂和传统C形臂引导进行脊柱骨母细胞瘤和骨样骨瘤手术治疗的结果。这是一项对2002年至2011年在我们机构接受治疗的脊柱骨样骨瘤和/或骨母细胞瘤患者的回顾性队列研究。本研究共检查了17例患者，其中7例为脊柱骨母细胞瘤，10例为脊柱骨样骨瘤。患者手术时的平均年龄为11.5±3.9岁。7例患者使用了O形臂，10例患者使用了C形臂。C形臂在1例中未能识别肿瘤，需要转运进行计算机断层扫描。使用O形臂时手术时间较短，尤其是在骨母细胞瘤组。13例患者在最后一次随访时无痛，2例患者复发。最后一次随访时的X线片未显示肿瘤切除后椎体不稳定的迹象。通过术中放射学引导，特别是使用O形臂三维导航系统，实现了脊柱肿瘤的安全有效定位以及手术中肿瘤切除的确认。
III级。
