Top

Acta Neurochirurgica

Published in:

01-04-2010 | Technical Note

Intra-operative MRI-assisted spinal localization

Authors: Chris Barrett, Philip English, Jerry Evans, Dipayan Mitra, Nicholas V. Todd

Published in: Acta Neurochirurgica | Issue 4/2010

Summary

Background

Level localization in the thoracic spine can be problematic. We describe a new method that can be used in difficult cases, e.g., ones where lesions are mid-thoracic, small, or only visible on MRI.

Methods

Intra-operatively, a midline incision was made and the thoracic spinous processes were exposed. A length of contrast-filled tubing was wound around the processes and the incision was temporarily closed and the patient was transferred to the radiology department for MRI under general anesthetic. Upon return to theatre, the cross sections of contrast-filled tubing and the lesion itself were visible on the MRI scan, allowing localization of the level.

Findings

This method was accurate and minimized the extent of bone removal required for access.

Conclusions

This technique, while not appropriate in every case, is repeatable, and does not require specialized equipment or training. It is an extremely accurate method of localization for difficult cases.

Barrett C, Jayakrishnan V, Gholkar A, Todd NV (2009) Coil embolisation of intercostal artery for operative localisation of spinal dural arterio-venous fistulae. Br J Neurosurg 23(3):332–334CrossRefPubMed

Cornips E, Beuls E, Geskes G, Janssens M, van Aalst J, Hofman P (2007) Preoperative localization of herniated thoracic discs using myelo-CT guided transpleural puncture: technical note. Childs Nerv Syst 23(1):21–26, Epub 2006 Aug 30CrossRefPubMed

Endres S, Riegel T, Wilke A (2005) Preoperative marking of thoracic disc herniation (in German). Orthopade 34(8):791–793CrossRefPubMed

Foley KT, Simon DA, Rampersaud YR (2001) Virtual fluoroscopy: computer-assisted fluoroscopic navigation. Spine 26(4):347–351CrossRefPubMed

Foley KT, Smith MM (1996) Image-guided spine surgery. Neurosurg Clin N Am 7(2):171–186PubMed

Haberland N, Ebmeier K, Grunewald JP, Hliscs R, Kalff RL (2000) Incorporation of intraoperative computerized tomography in a newly developed spinal navigation technique. Comput Aided Surg 5(1):18–27CrossRefPubMed

Holmaas G, Frederiksen D, Ulvik A, Vingsnes SO, Østgaard G, Nordli H (2006) Identification of thoracic intervertebral spaces by means of surface anatomy: a magnetic resonance imaging study. Acta Anaesthesiol Scand 50(3):368–373CrossRefPubMed

Hsu W, Sciubba DM, Sasson AD, Khavkin Y, Wolinsky JP, Gailloud P, Gokaslan ZL, Murphy K (2008) Intraoperative localization of thoracic spine level with preoperative percutaneous placement of intravertebral polymethylmethacrylate. J Spinal Disord Tech 21(1):72–75CrossRefPubMed

Kalfas IH, Kormos DW, Murphy MA, McKenzie RL, Barnett GH, Bell GR, Steiner CP, Trimble MB, Weisenberger JP (1995) Application of frameless stereotaxy to pedicle screw fixation of the spine. J Neurosurg 83(4):641–647CrossRefPubMed

10.

Nowitzke A, Wood M, Cooney K (2008) Improving accuracy and reducing errors in spinal surgery—a new technique for thoracolumbar-level localization using computer-assisted image guidance. Spine J 8(4):597–604, Epub 2007 Dec 21CrossRefPubMed

11.

Paolini S, Ciappetta P, Missori P, Raco A, Delfini R (2005) Spinous process marking: a reliable method for preoperative surface localization of intradural lesions of the high thoracic spine. Br J Neurosurg 19(1):74–76CrossRefPubMed

12.

Rosahl SK, Gharabaghi A, Liebig T, Feste CD, Tatagiba M, Samii M (2002) Skin markers for surgical planning for intradural lesions of the thoracic spine. Technical note. Surg Neurol 58(5):346–348CrossRefPubMed

13.

Tsai KJ, Chen SH, Chen PQ (2004) Multiple parallel skin markers for minimal incision lumbar disc surgery; a technical note. MC Musculoskelet Disord 5:8CrossRef

14.

Youkilis AS, Quint DJ, McGillicuddy JE, Papadopoulos SM (2001) Stereotactic navigation for placement of pedicle screws in the thoracic spine. Neurosurgery 48(4):771–778, discussion 778–9CrossRefPubMed

Title: Intra-operative MRI-assisted spinal localization
Authors: Chris Barrett
Philip English
Jerry Evans
Dipayan Mitra
Nicholas V. Todd
Publication date: 01-04-2010
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 4/2010
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-009-0543-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intra-operative MRI-assisted spinal localization

Summary

Background

Methods

Findings

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Summary

Background

Methods

Findings

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2010

Time to revisit VEP monitoring?

Capsules can replace the dura mater after cranial infection

Relationship between lectin-like oxidized low-density lipoprotein receptor 1 expression and preoperative echogenic findings of vulnerable carotid plaque

Ectopic choroid plexus associated with trigeminal neuralgia: case report

Effect of transcranial magnetic stimulation on four types of pressure-programmable valves

Lateral atlantoaxial facetal dislocation in craniovertebral region tuberculosis: report of a case and analysis of an alternative treatment