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Spine (Phila Pa 1976). 2008 Apr 20;33(9):E287-92. doi: 10.1097/BRS.0b013e31816d256e.

Computer-assisted surgical planning and image-guided surgical navigation in refractory adult scoliosis surgery: case report and review of the literature.

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1
Department of Orthopaedic Surgery, University of California, San Francisco, CA 94143, USA.

Abstract

STUDY DESIGN:

Case report and literature review.

OBJECTIVE:

In this case report, we present the utility of computer-assisted surgical planning and image-guided surgical navigation in the planning and execution of a major osteotomy to correct severe kyphoscoliosis.

SUMMARY OF BACKGROUND DATA:

Computer-assisted surgical planning is useful to appreciate the three-dimensional nature of scoliotic deformities and allows for operative maneuvers to be simulated on a computer before their implementation in the operating room. Image-guided surgical navigation improves surgical accuracy and can help translate a virtual surgical plan to the operative setting.

METHODS:

We report the case of a 38-year-old woman with severe, congenital kyphoscoliosis refractory to many previous surgeries, who presents with moderate progressive myelopathy and severe pain attributable to a sharp angular deformity at T12. Three-dimensional computed tomography reconstruction and computer-assisted surgical planning were used to determine the optimal corrective osteotomy. The surgical plan was translated to the operating room where a posterior vertebrectomy and instrumented correction were executed with the aid of image-guided surgical navigation.

RESULTS:

The osteotomy was safely performed resulting in improved sagittal and coronal alignments, as well as, correction of the sharp kyphoscoliotic deformity at the thoracolumbar junction. At 6-month follow-up, the patient's myelopathy and pain had largely resolved and she expressed high satisfaction with the procedure.

CONCLUSION:

We advocate this novel application of virtual surgical planning and intraoperative surgical navigation to improve the safety and efficacy of complex spinal deformity corrections.

PMID:
18427309
DOI:
10.1097/BRS.0b013e31816d256e
[Indexed for MEDLINE]
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