title: Ultrasound-based neuronavigation and spinal cord tumour surgery - marriage of convenience or notified incompatibility?
abstract: OBJECTIVE
  The study aimed to examine the position of three-dimensional (3D) neurosonography and the advantages and disadvantages of ultrasound-based neuronavigation in spinal cord tumour surgery.
  
  
  METHODS
  During the period July, 2007- February 2011, 28 patients with spinal cord tumours were operated in our neurosurgical clinic. All patients underwent intraoperative 3D neurosonography by means of SonoWandTM and SonoWand InviteTM ultrasound-based neuronavigation systems.
  
  
  RESULTS
  Intraoperative 3D neurosonography was used for 6 intramedullary tumours (5 ependymomas and 1 astrocytoma) and 22 extramedullary tumours (8 neurinomas, 10 meningiomas and 4 filum terminale ependymomas). During the performed spinal tumour surgery, snapshots of the 3D images of the surgical situation were obtained. Post-operative results, based on the control MRI findings and the patients' score on Karnofsky Performance Scale, were evaluated during the third month after the surgery.
  
  
  CONCLUSIONS
  Ultrasound-based neuronavigation is a promising tool in extramedullary tumour surgery, especially of meningiomas and neurinomas, ensuring better control on the extent of tumour excision. In patients with intramedullary tumours, however, the use of 3D neurosonography for more precise control on the extent of radical tumour excision is not possible. In general, ultrasound-based neuronavigation has not added much to the surgical management of spinal cord tumors.
authors.affiliation: Military Medical Academy, Department of Neurosurgery, Sofia, Bulgaria.
authors.forename: Todor
authors.initials: T
authors.lastname: Shamov
authors.forename: Tihomir
authors.initials: T
authors.lastname: Eftimov
authors.forename: Ara
authors.initials: A
authors.lastname: Kaprelyan
authors.forename: Yavor
authors.initials: Y
authors.lastname: Enchev
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D008579:Meningioma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D038361:Neuronavigation / Q000295:instrumentation / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D013116:Spinal Cord / Q000473:pathology / Q000601:surgery*; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014463:Ultrasonography