P Menchetti, G Canero, W Bini
P Menchetti, G Canero, W Bini. Neuronavigation Ct-Scan Guided In Minimal Invasive Spinal Surgery. The Internet Journal of Minimally Invasive Spinal Technology. 2006 Volume 1 Number 1.
The new concept of minimal invasive spinal surgery, nowdays appears strictly linked to the possibility of a surgical navigation guidance. Intraoperative CT-Scan multislices (Toshiba Aquilion 64 Slices) permits an accurate target respecting the coupling of a surgical approach faster and precise. In several fields of minimal invasive approach these techniques are applied (i.e.: percutaneously intradiscal treatments, vertebroplasty, kyphoplasty, bone spine tunors management and stereotaxis). In a comparative study on percutaneous Laser discectomy, a significant difference has been found under CT-Scan Multislices guidance in comparison to the standard C-arm guidance both in the success rate and in the possibility to treat successfully extruded disc. At the same time, the surgical treatment of vertebral fracture under CT-Scan permits to avoid the usual complications (bone cement leakage, pedicle fracture, and fracture disruption). Regarding bone spine tumors management a correct and very precise imaging give the right surgical target in order to practise minimal invasive treatment (alcholization in methastasis, RF thermal ablation, catheter insertion). Finally a neuronavigation guided cecking permits also to study correct positioning on vertebral implants after percutaneos arthrodesis. In conclusion the future of "less is better, less is more" seems joined to the new perspective to perform robot or imaging guided aided surgery, to optimize the surgical approach and permite the more accurate treatment.