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Augmented reality-mediated stereotactic navigation for execution of en bloc lumbar spondylectomy osteotomies.

Publication ,  Journal Article
Molina, CA; Dibble, CF; Lo, S-FL; Witham, T; Sciubba, DM
Published in: Journal of neurosurgery. Spine
March 2021

En bloc spinal tumor resections are technically demanding procedures with high morbidity because of the conventionally large exposure area and aggressive resection goals. Stereotactic surgical navigation presents an opportunity to perform the smallest possible resection plan while still achieving an en bloc resection. Augmented reality (AR)-mediated spine surgery (ARMSS) via a mounted display with an integrated tracking camera is a novel FDA-approved technology for intraoperative "heads up" neuronavigation, with the proposed advantages of increased precision, workflow efficiency, and cost-effectiveness. As surgical experience and capability with this technology grow, the potential for more technically demanding surgical applications arises. Here, the authors describe the use of ARMSS for guidance in a unique osteotomy execution to achieve an en bloc wide marginal resection of an L1 chordoma through a posterior-only approach while avoiding a tumor capsule breach. A technique is described to simultaneously visualize the navigational guidance provided by the contralateral surgeon's tracked pointer and the progress of the BoneScalpel aligned in parallel with the tracked instrument, providing maximum precision and safety. The procedure was completed by reconstruction performed with a quad-rod and cabled fibular strut allograft construct, and the patient did well postoperatively. Finally, the authors review the technical aspects of the approach, as well as the applications and limitations of this new technology.

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Published In

Journal of neurosurgery. Spine

DOI

EISSN

1547-5646

ISSN

1547-5654

Publication Date

March 2021

Volume

34

Issue

5

Start / End Page

700 / 705

Related Subject Headings

  • Orthopedics
  • 3209 Neurosciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Molina, C. A., Dibble, C. F., Lo, S.-F., Witham, T., & Sciubba, D. M. (2021). Augmented reality-mediated stereotactic navigation for execution of en bloc lumbar spondylectomy osteotomies. Journal of Neurosurgery. Spine, 34(5), 700–705. https://doi.org/10.3171/2020.9.spine201219
Molina, Camilo A., Christopher F. Dibble, Sheng-Fu Larry Lo, Timothy Witham, and Daniel M. Sciubba. “Augmented reality-mediated stereotactic navigation for execution of en bloc lumbar spondylectomy osteotomies.Journal of Neurosurgery. Spine 34, no. 5 (March 2021): 700–705. https://doi.org/10.3171/2020.9.spine201219.
Molina CA, Dibble CF, Lo S-FL, Witham T, Sciubba DM. Augmented reality-mediated stereotactic navigation for execution of en bloc lumbar spondylectomy osteotomies. Journal of neurosurgery Spine. 2021 Mar;34(5):700–5.
Molina, Camilo A., et al. “Augmented reality-mediated stereotactic navigation for execution of en bloc lumbar spondylectomy osteotomies.Journal of Neurosurgery. Spine, vol. 34, no. 5, Mar. 2021, pp. 700–05. Epmc, doi:10.3171/2020.9.spine201219.
Molina CA, Dibble CF, Lo S-FL, Witham T, Sciubba DM. Augmented reality-mediated stereotactic navigation for execution of en bloc lumbar spondylectomy osteotomies. Journal of neurosurgery Spine. 2021 Mar;34(5):700–705.

Published In

Journal of neurosurgery. Spine

DOI

EISSN

1547-5646

ISSN

1547-5654

Publication Date

March 2021

Volume

34

Issue

5

Start / End Page

700 / 705

Related Subject Headings

  • Orthopedics
  • 3209 Neurosciences
  • 1109 Neurosciences
  • 1103 Clinical Sciences