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Published in: Child's Nervous System 6/2021

Open Access 01-06-2021 | Scoliosis | Case Report

Lumbar hemivertebra resection in congenital scoliosis utilizing cone-beam navigation: less radiation, more accuracy—proof of concept

Authors: Christian Fisahn, Chris Lindemann, Brittni Burgess, Patrick Strube, Timo Zippelius

Published in: Child's Nervous System | Issue 6/2021

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Abstract

Purpose

To present the first known pediatric utilization of cone-beam navigation system (CBNS) for hemivertebra resection and spondylodesis

Case presentation

A 14-year-old female with congenital scoliosis, diagnosed at 8 years of age, presenting with progressive symptoms, a Cobb angle (L3-5) of 38° at time of surgery, treated historically with conservative measures. Presence of spinal intramedullary disease was excluded prior to operation via whole spine MRI.

Results

Patient successfully underwent surgical correction utilizing the CBNS (O-arm™, Medtronic®). Post-operative Cobb angle (L3-5) was restored to 8°. Following four different pediatric patient’s radiation exposures (two receiving correction via the O-arm platform and two via the traditional method employing fluoroscopy), we show a reduction in radiation exposure using the CBNS system.

Conclusion

We present the first known pediatric case of the utilization of the CBNS system for hemivertebra correction. We demonstrate that utilizing the CBNS platform can not only increase surgical accuracy but also decrease pediatric patient’s radiation exposure as a preoperative CT scan is not needed. Future studies should continue to explore additional benefits of implementing the system into surgical practice.
Literature
1.
go back to reference Johal J, Loukas M, Fisahn C, Chapman JR, Oskouian RJ, Tubbs RS (2016) Hemivertebrae: a comprehensive review of embryology, imaging, classification, and management. Childs Nerv Syst 32(11):2105–2109CrossRef Johal J, Loukas M, Fisahn C, Chapman JR, Oskouian RJ, Tubbs RS (2016) Hemivertebrae: a comprehensive review of embryology, imaging, classification, and management. Childs Nerv Syst 32(11):2105–2109CrossRef
2.
go back to reference Wax JR, Watson WJ, Miller RC, Ingardia CJ, Pinette MG, Cartin A, Grimes CK, Blackstone J (2008) Prenatal sonographic diagnosis of hemivertebrae: associations and outcomes. J Ultrasound Med 27(7):1023–1027CrossRef Wax JR, Watson WJ, Miller RC, Ingardia CJ, Pinette MG, Cartin A, Grimes CK, Blackstone J (2008) Prenatal sonographic diagnosis of hemivertebrae: associations and outcomes. J Ultrasound Med 27(7):1023–1027CrossRef
3.
go back to reference Xue X, Zhao S (2017) Revision surgery for lumbar hemivertebra in a 7-year-old child with 10-year follow-up-a case report: a CARE-compliant article. Medicine (Baltimore) 96(48):e8794CrossRef Xue X, Zhao S (2017) Revision surgery for lumbar hemivertebra in a 7-year-old child with 10-year follow-up-a case report: a CARE-compliant article. Medicine (Baltimore) 96(48):e8794CrossRef
4.
go back to reference Su AW, Luo TD, McIntosh AL, Schueler BA, Winkler JA, Stans AA, Larson AN (2016) Switching to a pediatric dose O-arm protocol in spine surgery significantly reduced patient radiation exposure. J Pediatr Orthop 36(6):621–626CrossRef Su AW, Luo TD, McIntosh AL, Schueler BA, Winkler JA, Stans AA, Larson AN (2016) Switching to a pediatric dose O-arm protocol in spine surgery significantly reduced patient radiation exposure. J Pediatr Orthop 36(6):621–626CrossRef
5.
go back to reference Miglioretti DL, Johnson E, Williams A, Greenlee RT, Weinmann S, Solberg LI, Feigelson HS, Roblin D, Flynn MJ, Vanneman N, Smith-Bindman R (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167(8):700–707CrossRef Miglioretti DL, Johnson E, Williams A, Greenlee RT, Weinmann S, Solberg LI, Feigelson HS, Roblin D, Flynn MJ, Vanneman N, Smith-Bindman R (2013) The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr 167(8):700–707CrossRef
Metadata
Title
Lumbar hemivertebra resection in congenital scoliosis utilizing cone-beam navigation: less radiation, more accuracy—proof of concept
Authors
Christian Fisahn
Chris Lindemann
Brittni Burgess
Patrick Strube
Timo Zippelius
Publication date
01-06-2021
Publisher
Springer Berlin Heidelberg
Keyword
Scoliosis
Published in
Child's Nervous System / Issue 6/2021
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-021-05055-5

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