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Single-center experience in resection of 120 cases of intradural spinal tumors – Lumbar Spinal Stenosis

The article presents a study conducted at a single center focusing on the resection of intradural spinal tumors using intraoperative CT-based registration and microscope-based augmented reality (AR). The study included 112 patients who underwent 120 surgeries, with a median follow-up of 39 months. The most common tumors were meningioma, schwannoma, and ependymomas. Results showed high rates of gross total resections with favorable neurological outcomes, and low recurrence rates with comparable complication rates. The use of AR improved intraoperative orientation by identifying important anatomical structures, although clinical and radiological outcomes did not differ when AR was not used. The study highlights the benefits of AR in spine surgery for enhanced surgical precision and patient outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spinal hospital in UK

Published article

CONCLUSION: High rates of GTR with favorable neurological outcome in a vast majority of patients as well as low recurrence rate with comparable complication rates was noted in our single center experience. AR improved intraoperative orientation and increased surgeons comfort by enabling early identification of important anatomical structures , however clinical and radiological outcomes did not differ, when AR was not used.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
World Neurosurg. 2024 Apr 18:S1878-8750(24)00634-X. doi: 10.1016/j.wneu.2024.04.071. Online ahead of print. ABSTRACT BACKGROUND: Our study presents a single center experience in resection of intradural spinal tumors either with or without using intraoperative CT (iCT)-based registration and microscope-based augmented reality (AR). Microscope-based AR was recently described for improved orientation in the operative field in spine surgery,

World Neurosurg. 2024 Apr 18:S1878-8750(24)00634-X. doi: 10.1016/j.wneu.2024.04.071. Online ahead of print.

ABSTRACT

BACKGROUND: Our study presents a single center experience in resection of intradural spinal tumors either with or without using intraoperative CT (iCT)-based registration and microscope-based augmented reality (AR). Microscope-based AR was recently described for improved orientation in the operative field in spine surgery, using superimposed images of segmented structures of interest in a two- (2D) or three-dimensional (3D) mode.

MATERIALS AND METHODS: All patients who underwent surgery for resection of intradural spinal tumors at our department were retrospectively included in the study. Clinical outcomes in terms of postoperative neurological deficits and complications were evaluated, as well as neuroradiological outcomes for tumor remnants and recurrence.

RESULTS: 112 patients (57 female, 55 male, median age 55.8 ± 17.8 years) who underwent 120 surgeries for resection of intradural spinal tumors with use of intraoperative neuromonitoring were included in the study, with median follow up of 39 ± 34.4 months. Nine patients died during the follow-up to reasons unrelated to surgery. Most common tumors were meningioma (n= 41), schwannoma (n= 37), myopapillary ependymomas (n= 12), ependymomas (n= 10), and others (20). Tumors were in thoracic spine (n= 46), lumbar spine (n= 39), cervical spine (n= 32), lumbosacral spine (n= 1), thoracic and lumbar spine (n= 1) and one tumor in cervical, thoracic, and lumbar spine. Four biopsies were performed, ten partial resections, 13 subtotal resections, and 93 gross total resections. Laminectomy was the common approach. In 79 cases, patients experienced neurological deficits prior to surgery, with ataxia and paraparesis as the most common ones. Following surgery, 67 cases were unchanged, in 49 improved and in 4 worsened. Operative time, extent of resection, clinical outcome and complication rate did not differ between the AR and non-AR group. However, use of AR improved orientation in the operative field by identification of important neurovascular structures.

CONCLUSION: High rates of GTR with favorable neurological outcome in a vast majority of patients as well as low recurrence rate with comparable complication rates was noted in our single center experience. AR improved intraoperative orientation and increased surgeons comfort by enabling early identification of important anatomical structures , however clinical and radiological outcomes did not differ, when AR was not used.

PMID:38642835 | DOI:10.1016/j.wneu.2024.04.071

The London Spine Unit : most established spinal hospital in UK

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Single-center experience in resection of 120 cases of intradural spinal tumors

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World Neurosurg. 2024 Apr 18:S1878-8750(24)00634-X. doi: 10.1016/j.wneu.2024.04.071. Online ahead of print. ABSTRACT BACKGROUND: Our study presents a single center experience in resection of intradural spinal tumors either with or without using intraoperative CT (iCT)-based registration and microscope-based augmented reality (AR). Microscope-based AR was recently described for improved orientation in the operative field in spine surgery

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