Chung-Wei Lin1, Chien-Chun Chang2, Hsien-Te Chen3, Yen-Jen Chen4, Chih-Sheng Lin5, Horng-Chaung Hsu6, Hsi-Kai Tsou7. 1. Department of Orthopedic Surgery, China Medical University Hospital, China Medical University, Taichung City, Taiwan (R.O.C.). 2. Department of Orthopedic Surgery, China Medical University Hospital, China Medical University, Taichung City, Taiwan (R.O.C.); Department of Biological Science and Technology, National Chiao Tung University, Hsinchu City, Taiwan (R.O.C.); Ph.D. Degree Program of Biomedical Science and Engineering, National Chiao Tung University, Hsinchu City, Taiwan (R.O.C.); Spine Center, China Medical University Hospital, China Medical University, Taichung City, Taiwan (R.O.C.). 3. Department of Orthopedic Surgery, China Medical University Hospital, China Medical University, Taichung City, Taiwan (R.O.C.); Department of Sports Medicine, College of Health Care, China Medical University, Taichung City, Taiwan (R.O.C.); Spine Center, China Medical University Hospital, China Medical University, Taichung City, Taiwan (R.O.C.). Electronic address: bonekid1@gmail.com. 4. Department of Orthopedic Surgery, China Medical University Hospital, China Medical University, Taichung City, Taiwan (R.O.C.); Spine Center, China Medical University Hospital, China Medical University, Taichung City, Taiwan (R.O.C.); School of Medicine, China Medical University, Taichung City, Taiwan (R.O.C.). 5. Department of Biological Science and Technology, National Chiao Tung University, Hsinchu City, Taiwan (R.O.C.); Ph.D. Degree Program of Biomedical Science and Engineering, National Chiao Tung University, Hsinchu City, Taiwan (R.O.C.). 6. Department of Orthopedic Surgery, China Medical University Hospital, China Medical University, Taichung City, Taiwan (R.O.C.); School of Medicine, China Medical University, Taichung City, Taiwan (R.O.C.). 7. Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, Taichung City, Taiwan (R.O.C.); Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County, Taiwan (R.O.C.).
Abstract
BACKGROUND: Surgical interventions for congenital scoliosis are challenging for spine surgeons. The coordination of 3-dimensional (3D), real-time, image-guided navigation with an ultrasonic bone cutter allows surgeons to localize the affected area of the spine accurately and remove the lesion without damaging soft tissue structures. The goal of this technical paper is to report a previously undescribed method of hemivertebrectomy that combines 3D, real-time, image-guided navigation and an ultrasonic bone cutter. We highlight the feasibility and safety of this method in spinal surgery. METHODS: Three patients with congenital scoliosis were treated with this technique. We present three illustrative cases comprising hemivertebrectomies for congenital scoliosis. Intraoperative photos demonstrating the technique are also provided. RESULTS: All surgeries were completed without complications. The hemivertebrae were completely removed, and marked correction of congenital scoliosis was noted. CONCLUSIONS: We believe that the combination of 3D, real-time image navigation and an ultrasonic bone cutter improves hemivertebrectomy by increasing accuracy and avoiding dura laceration, major organ damage, or potential vessel damage.
BACKGROUND: Surgical interventions for congenital scoliosis are challenging for spine surgeons. The coordination of 3-dimensional (3D), real-time, image-guided navigation with an ultrasonic bone cutter allows surgeons to localize the affected area of the spine accurately and remove the lesion without damaging soft tissue structures. The goal of this technical paper is to report a previously undescribed method of hemivertebrectomy that combines 3D, real-time, image-guided navigation and an ultrasonic bone cutter. We highlight the feasibility and safety of this method in spinal surgery. METHODS: Three patients with congenital scoliosis were treated with this technique. We present three illustrative cases comprising hemivertebrectomies for congenital scoliosis. Intraoperative photos demonstrating the technique are also provided. RESULTS: All surgeries were completed without complications. The hemivertebrae were completely removed, and marked correction of congenital scoliosis was noted. CONCLUSIONS: We believe that the combination of 3D, real-time image navigation and an ultrasonic bone cutter improves hemivertebrectomy by increasing accuracy and avoiding dura laceration, major organ damage, or potential vessel damage.