title: Navigated Iso-C3D-based percutaneous osteoid osteoma resection: a preliminary clinical report.
abstract: Minimally invasive osteoid osteoma resection under computer tomography (CT) guidance has yielded good results and has become a viable alternative to open surgical procedures. Limited visualization of the actual drill position under CT guidance can frequently result in inadequate and malpositioned drilling, especially at lesions located in less accessible anatomic regions. With the conventional CT-guided drilling technique, sterility and general operative management poorly correlate with standard operating room conditions, and are at risk of intra- and postoperative complications. The new Iso-C(3D) imaging device provides intraoperative multiplanar reconstructions. Adequate image quality and implementation in navigation systems were described for numerous indications. On the basis of multiplanar reconstructions, minimally invasive navigated techniques under three-dimensional surgical tool control become possible, which is not the case under fluoroscopic or CT-based navigation. We report on our first three cases of navigated Iso-C(3D) osteoid osteoma resection. A minimally invasive resection of the nidus was possible under permanent multiplanar image control. No complications were encountered and all patients reported successful outcomes. Minimally invasive-based navigation offered an effective and reproducible surgical approach. Dependence on CT imaging for proper positioning and complications associated with use away from the operating room environment can be avoided.
authors.affiliation: Trauma Department, Hannover Medical School, Hannover, Germany. notenuf@gmx.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Kendoff
authors.forename: Tobias
authors.initials: T
authors.lastname: Hüfner
authors.forename: Musa
authors.initials: M
authors.lastname: Citak
authors.forename: Jens
authors.initials: J
authors.lastname: Geerling
authors.forename: Eckhard
authors.initials: E
authors.lastname: Mössinger
authors.forename: Leonhard
authors.initials: L
authors.lastname: Bastian
authors.forename: Christian
authors.initials: C
authors.lastname: Krettek
mesh_terms: D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005471:Fluoroscopy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D019060:Minimally Invasive Surgical Procedures; D010017:Osteoma, Osteoid / Q000000981:diagnostic imaging / Q000601:surgery*; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome