Interactive image-guided surgery of the spine--use of the ISG/Elekta Viewing Wand to aid intraoperative localization of a sacral osteoblastoma.

The intraoperative localization of small osteoid osteomas and osteoblastomas of the spine is often difficult. The authors report a patient with a small sacral osteoblastoma in whom the experimental use of an Interactive Image-Guidance Stereotactic system, to aid localization, is described. The Elekta Viewing Wand is a spatial localization device primarily designed for intracranial procedures. We evaluated its potential role in the localization and minimally invasive excision of a sacral osteoblastoma in this patient. A basic assessment of the limitations encountered in extracranial use of this system is presented and possible solutions to minimize these problems are discussed.