Evaluation of the rate of decompression in anterior cervical corpectomy using an intra-operative computerized tomography scan (O-Arm system)

被引:14
作者
Costa, Francesco [1 ]
Tomei, Massimo [2 ]
Sassi, Marco [2 ]
Cardia, Andrea [1 ]
Ortolina, Alessandro [1 ]
Servello, Domenico [2 ]
Fornari, Maurizio [1 ]
机构
[1] IRCCS, Ist Clin Humanitas, Neurosurg Dept, Rozzano, MI, Italy
[2] Ist IRCCS Galeazzi, Neurosurg Dept, I-20100 Milan, Italy
基金
英国惠康基金; 美国国家卫生研究院;
关键词
Cervical corpectomy; O-Arm system; Myelopathy; Intra-operative CT; Decompression; MYELOPATHY; ADEQUACY; SURGERY;
D O I
10.1007/s00586-011-2028-7
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
The purpose of this study was to evaluate the efficacy of intra-operative computerized tomography (CT) scanning in the analysis of bone removal accuracy during anterior cervical corpectomy, in order to allow any necessary immediate correction in the event of inadequate bone removal. From September 2009 to December 2010 we performed an intra-operative (CT) scan using the O-Arm((TM)) Image system to assess the rate of central and lateral decompression in all patients treated for cervical spondylotic myelopathy by anterior cervical corpectomy and fusion. Out of a population of 187 patients admitted to our department, with a diagnosis of myelopathy due to spondylotic degenerative cervical stenosis, 15 patients underwent a surgical treatment with anterior cervical corpectomy and fusion. There were nine males (60%) and six females (40%); the mean age was 52.4 years, ranging from 41 to 57 years. The pre-operative radiologic investigations (MRI and CT scans) revealed in the nine patients (60%) the extent of the compression to one vertebral body (C4 one case, C5 four cases, C6 four cases), while in the six cases (40%) the compression regarded two vertebral body (C3 and C4 one case, C4 and C5 two cases, C5 and C6 three cases). During surgery, when the decompression was judged completely, a CT scan was performed: in 11 cases (73.3%) the decompression was considered adequate, while in four cases (26.7%) it was deemed insufficient and the surgical strategy was changed in order to optimize the bone removal. In these cases an additional scan was taken to prove the efficacy of decompression, achieved in all patients. Intra-operative CT scan performed during cervical corpectomy is a really useful tool in helping to ensure complete bone removal and the adequacy of surgery. The O-arm((TM)) Image system grants optimal image quality, allowing correctly assessing the rate of decompression and, in any case of doubt, allows an intra-operative evaluation of the final correct positioning of the graft.
引用
收藏
页码:359 / 363
页数:5
相关论文
共 26 条
[1]   Image-guided anterior cervical corpectomy - A feasibility study [J].
Albert, TJ ;
Klein, GR ;
Vaccaro, AR .
SPINE, 1999, 24 (08) :826-830
[2]  
Asgari S., 1996, Neurosurgery '96. Manual of neurosurgery, P750
[3]   Cervical spondylotic myelopathy: 10 years of prospective outcome analysis of anterior decompression and fusion [J].
Chagas, H ;
Domingues, F ;
Aversa, A ;
Fonseca, ALV ;
de Souza, JM .
SURGICAL NEUROLOGY, 2005, 64 :S30-S36
[4]  
Cooper PR, 1992, DEGENERATIVE DIS CER, P73
[5]  
Costa F, 2011, NEUROSURG Q IN PRESS
[6]  
Costa F, 2011, SPINE PHILA PA 1976
[7]   CERVICAL SPONDYLOTIC MYELOPATHY [J].
CRANDALL, PH ;
BATZDORF, U .
JOURNAL OF NEUROSURGERY, 1966, 25 (01) :57-+
[8]   Intraoperative evaluation of bone decompression in anterior cervical spine surgery by three-dimensional fluoroscopy [J].
Deinsberger, R ;
Regatschnig, R ;
Ungersböck, K .
EUROPEAN SPINE JOURNAL, 2005, 14 (07) :671-676
[9]   Surgical management of cervical degenerative disease: the evidence related to indications, impact, and outcome [J].
Fehlings, Michael G. ;
Arvin, Babak .
JOURNAL OF NEUROSURGERY-SPINE, 2009, 11 (02) :97-100
[10]   Artificial lamina-assisted laminoplasty performed in seven cases [J].
Fornari, M ;
Luccarelli, G ;
Giombini, S ;
Chiapparini, L .
JOURNAL OF NEUROSURGERY, 1999, 91 (01) :43-49