Image-guided surgery in resection of benign cervicothoracic spinal tumors: a report of two cases.
BACKGROUND
Osseous spinal tumors are an uncommon cause of persistent axial pain and muscle spasm, but even benign lesions may grow to cause deformity or neurological signs. Traditional treatment approaches to resection can be debilitating even when the tumor is benign.


OBJECTIVE
Emerging technologies allow surgeons to diagnose and treat osseous neoplasms while minimizing the collateral damage caused by surgical exposure and tumor excision.


METHODS
Technical considerations are presented through two cases of benign osseous neoplasm occurring in the cervicothoracic spine of competitive athletes, demonstrating the meth-ods used to provide effective treatment while maintaining maximal functional capacity.


METHODS
Stereotactic imaging and intraoperative guidance was used as an adjunct to tumor care in these patients. Used in combination with minimally invasive, microsurgical techniques,stereotactic guidance localized and verified excision margins of benign vertebral lesions, minimizing soft tissue trauma and collateral damage.


RESULTS
Computer-assisted stereotactic localization allowed us to successfully ablate these lesions from their anatomically challenging locations, without disrupting the shoulder girdle or neck musculature, and without extensive bony resection.


CONCLUSIONS
Image guidance can accurately localize and guide excision of benign vertebral lesions while minimizing soft tissue trauma and collateral damage, allowing patients a rapid and complete return to high-demand function.
Moore
Timothy
T
Department of Orthopedic Surgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
McLain
Robert F
RF
D000293:Adolescent; D000328:Adult; D002574:Cervical Vertebrae; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D018215:Osteoblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010147:Pain Measurement; D011379:Prognosis; D020127:Recovery of Function; D018570:Risk Assessment; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D013238:Stereotaxic Techniques; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome