Safety and Feasibility of Augmented Reality Assistance in Minimally Invasive and Open Resection of Benign Intradural Extramedullary Tumors

Fabian Sommer; Ibrahim Hussain; Sertac Kirnaz; Jacob Goldberg; Lynn McGrath; Rodrigo Navarro-Ramirez; Francois Waterkeyn; Franziska Schmidt; Pravesh Shankar Gadjradj; Roger Härtl

doi:10.14245/ns.2244222.111

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저자정보: Fabian Sommer (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Ibrahim Hussain (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Sertac Kirnaz (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Jacob Goldberg (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Lynn McGrath (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Rodrigo Navarro-Ramirez (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Francois Waterkeyn (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Franziska Schmidt (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Pravesh Shankar Gadjradj (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine) Roger Härtl (Department of Neurosurgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine)

저널정보: 대한척추신경외과학회 Neurospine Neurospine 제19권 제3호

발행연도: 2022.9

수록면: 501 - 512 (12page)

DOI: 10.14245/ns.2244222.111

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Objective: Surgical resection of benign intradural extramedullary tumors (BIETs) is effec tive for appropriately selected patients. Minimally invasive surgical (MIS) techniques have been described for successful resection of BIET while minimizing soft tissue injury. Aug mented reality (AR) is a promising new technology that can accurately allow for intraopera tive localization from skin through the intradural compartment. We present a case series evaluating the timing, steps, and accuracy at which this technology is able to enhance BIET resection. Methods: A protocol for MIS and open AR-guided BIET resection was developed and ap plied to determine the feasibility. The tumor is marked on diagnostic magnetic resonance imaging (MRI) using AR software. Intraoperatively, the planning MRI is fused with the in traoperative computed tomography. The position and size of the tumor is projected into the surgical microscope and directly into the surgeon's field of view. Intraoperative orientation is performed exclusively via navigation and AR projection. Demographic and perioperative factors were collected. Results: Eight patients were enrolled. The average operative time for MIS cases was 128 ± 8 minutes and for open cases 206 ± 55 minutes. The estimated intraoperative blood loss was 97 ± 77 mL in MIS and 240 ± 206 mL in open procedures. AR tumor location and margins were considered sufficiently precise by the surgeon in every case. Neither correction of the approach trajectory nor ultrasound assistance to localize the tumor were necessary in any case. No intraoperative complications were observed. Conclusion: Current findings suggest that AR may be a feasible technique for tumor local ization in the MIS and open resection of benign spinal extramedullary tumors.

#Minimally invasive surgery #Benign extramedullary intradural tumor #Augment ed Reality #benign intradural extramedullary tumor

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Fabian Sommer

소속기관 Department of Neurological Surgery Weill Cornell Medicine New York Presbyterian Hospital/Och Spine

주요연구분야 의약학 > 임상의학 > 신경외과학

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Ibrahim Hussain