Abstract:
BACKGROUND:Recently, novel mobile intraoperative fan-beam computed tomography (CT) was introduced, allowing for real-time navigation and immediate intraoperative evaluation of neural decompression in spine surgery. This study sought to investigate whether intraoperatively assessed neural decompression during minimally invasive spine surgery (MISS) has a predictive value for clinical and radiographic outcome. METHODS:A retrospective study of patients undergoing intraoperative CT (iCT)-guided extreme lateral interbody fusion or transforaminal lumbar interbody fusion was conducted. 1) Preoperative, 2) intraoperative (after cage implantation, 3) postoperative, and 4) follow-up radiographic and clinical parameters obtained from radiography or CT were quantified. RESULTS:Thirty-four patients (41 spinal segments) were analyzed. iCT-based navigation was successfully accomplished in all patients. Radiographic parameters showed significant improvement from preoperatively to intraoperatively after cage implantation in both MISS procedures (extreme lateral interbody fusion/transforaminal lumbar interbody fusion) (P ≤ 0.05). Radiologic parameters for both MISS fusion procedures did not show significant differences to the assessed radiographic measures at follow-up (P > 0.05). Radiologic outcome values did not decrease when compared intraoperatively (after cage implantation) to latest follow-up. CONCLUSIONS:Intraoperative fan-beam CT is capable of assessing neural decompression intraoperatively with high accuracy, allowing for precise prediction of radiologic outcome and earliest possible feedback during MISS fusion procedures. These findings are highly valuable for routine practice and future investigations toward finding a threshold for neural decompression that translates into clinical improvement. If sufficient neural decompression has been confirmed with iCT imaging studies, additional postoperative and/or follow-up imaging studies might no longer be required if patients remain asymptomatic.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Janssen I,Lang G,Navarro-Ramirez R,Jada A,Berlin C,Hilis A,Zubkov M,Gandevia L,Härtl Rdoi
10.1016/j.wneu.2017.07.167subject
Has Abstractpub_date
2017-11-01 00:00:00pages
322-333eissn
1878-8750issn
1878-8769pii
S1878-8750(17)31267-6journal_volume
107pub_type
杂志文章abstract::Gross total resection of large intracranial meningiomas (LIMs) can be challenging and cause significant morbidity and mortality. The aim of this systematic review is to determine the clinical effectiveness and safety of stereotactic radiosurgery (SRS) either as primary or adjuvant therapy for LIMs with tumors ≥2.5 cm ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.06.064
更新日期:2019-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.089
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.02.004
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.186
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.11.108
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journal_title:World neurosurgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.wneu.2019.11.134
更新日期:2020-03-01 00:00:00
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2019.05.070
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2018-12-01 00:00:00
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journal_title:World neurosurgery
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更新日期:2020-11-01 00:00:00
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更新日期:2014-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2018-11-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
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更新日期:2019-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.01.010
更新日期:2014-05-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.04.024
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journal_title:World neurosurgery
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1016/j.wneu.2018.05.169
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pub_type: 杂志文章,评审
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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更新日期:2020-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.02.187
更新日期:2019-07-01 00:00:00
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journal_title:World neurosurgery
pub_type: 历史文章,杂志文章,评审
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更新日期:2018-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.03.007
更新日期:2017-06-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2018-09-01 00:00:00
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journal_title:World neurosurgery
pub_type:
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更新日期:2020-04-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.07.283
更新日期:2018-11-01 00:00:00