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KMID : 0388720240310010010
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Journal of Korean Society of Spine Surgery
2024 Volume.31 No. 1 p.10 ~ p.17
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The Role of Intraoperative Navigation in Guiding Spine Tumor Resection for Achieving an Adequate Surgical Margin: An Institutional Case Series
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Kim Sang-Il
Samarth Mittal
Ko Young-Il
Ko Myung-Sup
Kim Young-Hoon
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Abstract
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Study Design: Case series Objective: This study aimed to assess the proportion of adequate surgical margins in spine tumor resection procedures using O-arm navigation-assisted surgery, and to examine the associated oncologic outcomes.
Summary of Literature Review: Computed tomography (CT)-based intraoperative navigation has been relatively recently adopted for spine tumor surgery. However, whether navigation-assisted surgery shortens procedures and leads to better clinical outcomes remains unclear.
Materials and Methods: A retrospective review was conducted on seven patients who underwent tumor resection with O-arm navigation assistance. Clinical data such as general demographic characteristics, intraoperative efficacy of this system for reconstruction, perioperative complications, oncologic outcomes, and pathological reviews of the surgical margins were collected.
Results: No intraoperative complications were associated with the use of the navigation system. In terms of oncological outcomes, six patients survived, with five showing no evidence of disease and one remaining alive with disease. One patient died after a 6-month follow-up period. Navigation proved beneficial in achieving negative resection margins in six out of seven patients (85.7%), while only one patient with solitary metastasis showed margin involvement of the tumor. Among the six surviving patients, one with sacral osteosarcoma (16.7%) experienced local recurrence due to a satellite lesion, leading to revision surgery.
Conclusions: CT-based navigation-assisted surgery for spinal tumors could be useful not only for accurate reconstruction, but also for determining the surgical margin. A thorough preoperative radiological review and intraoperative navigation could provide additional benefits for a safe resection margin.
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KEYWORD
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Spine tumor, Navigation-assisted surgery, Local recurrence, Surgical margin
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