title: Frameless stereotaxy to facilitate anterolateral thoracolumbar surgery: technique.
abstract: With the advent of frameless stereotaxy and its application to the spine, more precise and less invasive spinal procedures are possible. In addition to being less invasive, these techniques may increase surgeon confidence and allow shorter operating times. Described here is a case of Pott's disease of the thoracolumbar spine and how intraoperative image guidance can facilitate operative progress and accuracy in a patient in whom the underlying disease has severely deformed the normal anatomy of the spine. Added confidence about the location of vital structures as the surgeon proceeds with resection of the vertebral bodies and discs is depicted. Facilitation with image-guided placement of bicortical vertebral body screws and an interbody device is demonstrated. A diagram of the recommended positioning of the equipment in the operating room is provided along with "pearls" learned from our experience with this application. We believe that even the most experienced and skilled surgeon will find facilitation of anterior thoracolumbar surgery with image guidance to be of considerable benefit.
authors.affiliation: Department of Neurological Surgery, University of California at Irvine, Orange, California 92868-3298, USA. echappel@uci.edu
authors.forename: E Thomas
authors.initials: ET
authors.lastname: Chappell
authors.forename: Laura
authors.initials: L
authors.lastname: Pare
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Dolich
authors.forename: Michael E
authors.initials: ME
authors.lastname: Lekawa
authors.forename: Mohammed
authors.initials: M
authors.lastname: Salepour
mesh_terms: D001416:Back Pain / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000295:instrumentation; D011859:Radiography; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*