Augmented Reality Neuronavigation for En Bloc Resection of Spinal Column Lesions.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Nov 2022
Historique:
received: 11 07 2022
revised: 28 08 2022
accepted: 30 08 2022
pubmed: 13 9 2022
medline: 18 2 2023
entrez: 12 9 2022
Statut: ppublish

Résumé

Primary tumors involving the spine are relatively rare but represent surgically challenging procedures with high patient morbidity. En bloc resection of these tumors necessitates large exposures, wide tumor margins, and poses risks to functionally relevant anatomical structures. Augmented reality neuronavigation (ARNV) represents a paradigm shift in neuronavigation, allowing on-demand visualization of 3D navigation data in real-time directly in line with the operative field. Here, we describe the first application of ARNV to perform distal sacrococcygectomies for the en bloc removal of sacral and retrorectal lesions involving the coccyx in 2 patients, as well as a thoracic 9-11 laminectomy with costotransversectomy for en bloc removal of a schwannoma in a third patient. In our experience, ARNV allowed our teams to minimize the length of the incision, reduce the extent of bony resection, and enhanced visualization of critical adjacent anatomy. All tumors were resected en bloc, and the patients recovered well postoperatively, with no known complications. Pathologic analysis confirmed the en bloc removal of these lesions with negative margins. We conclude that ARNV is an effective strategy for the precise, en bloc removal of spinal lesions including both sacrococcygeal tumors involving the retrorectal space and thoracic schwannomas.

Sections du résumé

BACKGROUND BACKGROUND
Primary tumors involving the spine are relatively rare but represent surgically challenging procedures with high patient morbidity. En bloc resection of these tumors necessitates large exposures, wide tumor margins, and poses risks to functionally relevant anatomical structures. Augmented reality neuronavigation (ARNV) represents a paradigm shift in neuronavigation, allowing on-demand visualization of 3D navigation data in real-time directly in line with the operative field.
METHODS METHODS
Here, we describe the first application of ARNV to perform distal sacrococcygectomies for the en bloc removal of sacral and retrorectal lesions involving the coccyx in 2 patients, as well as a thoracic 9-11 laminectomy with costotransversectomy for en bloc removal of a schwannoma in a third patient.
RESULTS RESULTS
In our experience, ARNV allowed our teams to minimize the length of the incision, reduce the extent of bony resection, and enhanced visualization of critical adjacent anatomy. All tumors were resected en bloc, and the patients recovered well postoperatively, with no known complications. Pathologic analysis confirmed the en bloc removal of these lesions with negative margins.
CONCLUSIONS CONCLUSIONS
We conclude that ARNV is an effective strategy for the precise, en bloc removal of spinal lesions including both sacrococcygeal tumors involving the retrorectal space and thoracic schwannomas.

Identifiants

pubmed: 36096393
pii: S1878-8750(22)01259-1
doi: 10.1016/j.wneu.2022.08.143
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102-110

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Auteurs

Seth S Tigchelaar (SS)

Department of Neurosurgery, Stanford University Medical Center, Stanford, California, USA. Electronic address: stigchel@stanford.edu.

Zachary A Medress (ZA)

Department of Neurosurgery, Stanford University Medical Center, Stanford, California, USA.

Jennifer Quon (J)

Department of Neurosurgery, Stanford University Medical Center, Stanford, California, USA.

Phuong Dang (P)

Surgical Theater, Inc., Cleveland, Ohio, USA.

Daniela Barbery (D)

Surgical Theater, Inc., Cleveland, Ohio, USA.

Aidan Bobrow (A)

Surgical Theater, Inc., Cleveland, Ohio, USA.

Cindy Kin (C)

Department of Surgery, Stanford University Medical Center, Stanford, California, USA.

Robert Louis (R)

The Brain and Spine Center, Hoag Memorial Hospital Presbyterian Newport Beach, Newport Beach, California, USA; Pickup Family Neurosciences Institute, Hoag Memorial Hospital Presbyterian Newport Beach, Newport Beach, California, USA.

Atman Desai (A)

Department of Neurosurgery, Stanford University Medical Center, Stanford, California, USA.

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Classifications MeSH