Intra-operative MRI-assisted spinal localization.
BACKGROUND
Level localization in the thoracic spine can be problematic. We describe a new method that can be used in difficult cases, e.g., ones where lesions are mid-thoracic, small, or only visible on MRI.


METHODS
Intra-operatively, a midline incision was made and the thoracic spinous processes were exposed. A length of contrast-filled tubing was wound around the processes and the incision was temporarily closed and the patient was transferred to the radiology department for MRI under general anesthetic. Upon return to theatre, the cross sections of contrast-filled tubing and the lesion itself were visible on the MRI scan, allowing localization of the level.


RESULTS
This method was accurate and minimized the extent of bone removal required for access.


CONCLUSIONS
This technique, while not appropriate in every case, is repeatable, and does not require specialized equipment or training. It is an extremely accurate method of localization for difficult cases.
Barrett
Chris
C
Department of Neurosurgery, Regional Neurosciences Centre, Newcastle General Hospital, Newcastle Upon Tyne, UK. chris.barrett@nuth.nhs.uk
English
Philip
P
Evans
Jerry
J
Mitra
Dipayan
D
Todd
Nicholas V
NV
D000293:Adolescent; D003287:Contrast Media / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004806:Ependymoma / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D015174:Epidural Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D005471:Fluoroscopy / Q000379:methods; D005682:Gadolinium; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007796:Laminectomy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008348:Manikins; D008953:Models, Anatomic; D012086:Reoperation; D012680:Sensitivity and Specificity; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013904:Thoracic Vertebrae / Q000473:pathology / Q000601:surgery*
D003287:Contrast Media; D005682:Gadolinium