Image-guided multilevel vertebral osteotomies for en bloc resection of giant cell tumor of the thoracic spine: case report and description of operative technique.

The use of frameless stereotactic navigation is gaining popularity in spinal surgery. Although initially used in the spine for placement of lumbar pedicle screws, this technology has expanded to facilitate placement of spinal instrumentation at virtually all spinal levels. While previous reports have described the utility of image guidance for placement of spinal instrumentation, its use in assisting with resection of complex spine tumors has not been extensively reported. Here we describe the use of frameless stereotaxy to guide a complex, four-level sagittal vertebral osteotomy for en bloc resection of a giant cell tumor involving the chest wall and thoracic spine.