gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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The use of intraoperative CT neuronavigation for dorsal cervical spine procedures promises a better intraoperative orientation in special cases

Meeting Abstract

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  • Stefan Linsler - Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
  • Sebastian Antes - Universitätskliniken des Saarlandes, Klinik für Neurochirurgie, Homburg/Saar, Deutschland
  • Joachim Oertel - Universitätskliniken des Saarlandes, Neurochirurgische Klinik, Klinik für Neurochirurgie, Homburg/Saar, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.26.07

doi: 10.3205/17dgnc161, urn:nbn:de:0183-17dgnc1619

Published: June 9, 2017

© 2017 Linsler et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.