Welch W C, Subach B R, Pollack I F, Jacobs G B
Department of Neurological Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA.
Neurosurgery. 1997 May;40(5):958-63; discussion 963-4. doi: 10.1097/00006123-199705000-00016.
The goal was to evaluate and describe the use of a frameless, computed tomography-guided, stereotactic technique in complex procedures involving the craniocervical junction.
Eleven procedures, including transoral odontoid resection, posterior atlantoaxial fusion with transarticular C1-C2 screw fixation, and spinal tumor resection, were performed in the preceding 26 months. In each case, frameless stereotaxy was used to plan the incision, to define resection margins, and to determine the appropriate orientation of instrumentation.
There were no intraoperative complications noted. Each patient underwent adequate resection of the pathological lesion and satisfactory placement of instrumentation. The stereotactic system provided detailed anatomic visualization, which increased the confidence of the surgeon during the procedure. The system limited the need for extensive surgical exposure, reduced fluoroscopy time, and decreased the risk of neurovascular injury.
Frameless stereotaxy provided the surgeon with intraoperative information regarding the extent of bone and soft tissue resection. It provided a multidimensional view of anatomic relationships in the operative field, which significantly increased surgical accuracy and safety.
评估并描述在涉及颅颈交界区的复杂手术中使用无框架计算机断层扫描引导立体定向技术的情况。
在之前的26个月内进行了11例手术，包括经口齿状突切除术、经关节突C1-C2螺钉固定的后路寰枢椎融合术以及脊柱肿瘤切除术。在每例手术中，使用无框架立体定向技术来规划切口、确定切除边缘并确定器械的合适方向。
术中未发现并发症。每位患者均对病理性病变进行了充分切除，器械放置满意。立体定向系统提供了详细的解剖可视化，增加了手术过程中外科医生的信心。该系统减少了广泛手术暴露的需求，缩短了透视时间，并降低了神经血管损伤的风险。
无框架立体定向技术为外科医生提供了术中有关骨和软组织切除范围的信息。它提供了手术视野中解剖关系的多维度视图，显著提高了手术的准确性和安全性。
