a Department of Orthopaedic Surgery, Faculty of Medicine , The University of Tokyo , Tokyo , Japan.
b Department of Orthopaedic Surgery , Saitama Medical Center, Jichi Medical University , Saitama , Japan.
Comput Assist Surg (Abingdon). 2017 Dec;22(1):14-19. doi: 10.1080/24699322.2017.1282044.
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome usually caused by phosphaturic mesenchymal tumors. Segmental resection has been recommended for these tumors in the bones because curettage was found to be associated with a high local recurrence rate. Navigation-assisted surgery provides radiological information to guide the surgeon during surgery. No previous study has reported on the efficacy of navigation-assisted surgery for tumors in patients with TIO. Therefore, the present study aimed to evaluate the efficacy of navigation-assisted surgery for tumors in patients with TIO.
The study included seven patients with TIO who were treated between January 2003 and December 2014 at our hospital. All patients underwent surgical treatment with or without the use of a 3-dimensional (3D) fluoroscopy-based navigation system. The laboratory data and oncological outcomes were evaluated.
The follow-up period was 8-128 months. The tumors were located at the femur (n = 4), ischium, spine and ilium (n = 1). Of the seven patients, five underwent navigation-assisted surgery and two underwent surgery without navigation assistance. In the two patients who underwent surgery without navigation assistance, a complete cure was not obtained and osteomalacia did not resolve. One of these two patients and the other five patients who underwent navigation-assisted surgery, one patient had incomplete resection due to massive invasion of the tumor into the spinal canal, but five patients achieved complete excision and recovered from osteomalacia.
Navigation-assisted surgery using a 3D fluoroscopy-based navigation system is effective for tumors in patients with TIO.
肿瘤相关性骨软化症（TIO）是一种罕见的副瘤综合征，通常由磷酸化解质肿瘤引起。这些骨内肿瘤推荐采用节段切除术，因为刮除术被发现与高局部复发率相关。导航辅助手术提供放射学信息，以指导外科医生在手术过程中进行操作。目前尚无研究报道导航辅助手术治疗 TIO 患者肿瘤的疗效。因此，本研究旨在评估导航辅助手术治疗 TIO 患者肿瘤的疗效。
本研究纳入了 2003 年 1 月至 2014 年 12 月在我院接受治疗的 7 例 TIO 患者。所有患者均采用或不采用基于三维（3D）透视的导航系统进行手术治疗。评估了实验室数据和肿瘤学结果。
随访时间为 8-128 个月。肿瘤位于股骨（n=4）、坐骨、脊柱和髂骨（n=1）。7 例患者中，5 例行导航辅助手术，2 例行无导航辅助手术。在 2 例行无导航辅助手术的患者中，未获得完全治愈，骨软化症未缓解。这 2 例患者中的 1 例和另 5 例行导航辅助手术的患者中，1 例因肿瘤广泛侵犯椎管而无法完全切除，但 5 例患者实现了完全切除并从骨软化症中恢复。
使用基于 3D 透视的导航系统的导航辅助手术对 TIO 患者的肿瘤有效。
