Artikel
The use of intraoperative CT neuronavigation for dorsal cervical spine procedures promises a better intraoperative orientation in special cases
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Autoren
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Stefan Linsler
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
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Sebastian Antes
- Universitätskliniken des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
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Joachim Oertel
- Universitätskliniken des Saarlandes, Neurochirurgische Klinik, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
| Veröffentlicht: | 9. Juni 2017 |
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Gliederung
Text
Objective: The safety and efficiency of cervical spine surgery can be enhanced by accurate navigation in preoperative CT and MRI. Here we report our initial experience of real-time intraoperative computed tomography-guided navigation for cervical spine surgery via dorsal approach.
Methods: We report about 10 cases with dorsal cervical spine procedures. In 4 of these cases we performed an endoscopic Frykholm procedure of C6/7 or C7/Th1. In 6 cases were performed a laminectomy and dorsal fusion with massae lateralis screws. In all these cases we used Medtronic Stealth Air System which was registrated via intraoperative CT scan (Siemens CT Somatom suite) to enable 3D navigation based on MR and CT imaging data.
Results: Three-dimensional (3D)-based computer navigation prolonged the duration of preoperative setting but helped to reduce the radiation emitted and led to significantly increased accuracy of identification of the surgical target at the cervical spine. In 4 of 4 cases the neuroforamen could be identified correctly with neuronavigation. In all cases of instrumentation the anatomical landmarks of the massae lateralis were excellent. There was an adjustment of less than 1 mm in all cases. In all cases the identification of neuroforamen was possible from level C5 to Th2 which was not possible with lateral fluoroscopy in these cases.
Conclusion: The use of intraoperative CT/MR imaging-guided neuronavigation for cervical spine surgery is a time-effective, safe, and technically beneficial technique. Especially the identification of levels C6 to Th2 is more safely possible than in lateral fluoroscopy.
