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Intraoperative Stereotactic Arteriography in Complex Cervical Spine Surgery.

التفاصيل البيبلوغرافية
العنوان: Intraoperative Stereotactic Arteriography in Complex Cervical Spine Surgery.
المؤلفون: Mugge L; Department of Neurosurgery, Inova Neuroscience and Spine Institute, Falls Church, USA., Dang DD; Department of Neurosurgery, Inova Neuroscience and Spine Institute, Falls Church, USA., Ziu M; Department of Neurosurgery, Inova Neuroscience and Spine Institute, Fairfax, USA., Fanous A; Department of Neurosurgery, Inova Neuroscience and Spine Institute, Falls Church, USA.
المصدر: Cureus [Cureus] 2024 Mar 23; Vol. 16 (3), pp. e56783. Date of Electronic Publication: 2024 Mar 23 (Print Publication: 2024).
نوع المنشور: Case Reports
اللغة: English
بيانات الدورية: Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Palo Alto, CA : Cureus, Inc.
مستخلص: Intra-operative navigation has revolutionized spinal instrumentation. The O-arm (a mobile X-ray system; Medtronic, Minneapolis, MN) is uniquely capable of enabling visualization of the spine in axial planes. The application of this technology is wide yet underutilized in terms of its capacity to image spinal vascular anatomy. We completed a retrospective chart review of the following case studies. A 24-year-old neurologically intact female presented with a Jefferson fracture without vertebral artery dissection after a motor vehicle accident. After the failure of conservative management due to pseudoarthrosis, the patient opted for fusion. Prior to the procedure, bilateral 5 French femoral sheaths were placed. After exposure, intraarterial (IA) contrast was injected prior to the O-arm spin to visualize both vertebral arteries, which were stretched and adjacent to a mobile boney segment. In the second case, a 71-year-old male presented with right shoulder pain and a flaccid left deltoid secondary to a large enhancing epidural lesion spanning C4-C7. Further work-up confirmed a diagnosis of metastatic intrahepatic cholangiocarcinoma. Prior to resection with cervical spinal stabilization, a right radial artery 4 French Glidesheath was placed. Prior to the O-arm spin, the right vertebral artery was selected, and intravenous contrast was injected to permit visualization of the vertebral artery, which was encased within the tumor and at significant risk for iatrogenic injury. Both patients tolerated the endovascular and spinal procedures well without vertebral artery injury. This is the first series to report the effective use of the O-arm for improved visualization of vascular anatomy during surgery for cervical spinal trauma and oncology.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2024, Mugge et al.)
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فهرسة مساهمة: Keywords: angiogram; cervical spine; o-arm; stereotaxis; vertebral artery
تواريخ الأحداث: Date Created: 20240423 Latest Revision: 20240426
رمز التحديث: 20240426
مُعرف محوري في PubMed: PMC11034618
DOI: 10.7759/cureus.56783
PMID: 38650816
قاعدة البيانات: MEDLINE
الوصف
تدمد:2168-8184
DOI:10.7759/cureus.56783