Interest of computer assisted surgery (CAS) in the excision of osteoid osteoma by using fluoroscopy-based navigation

摘要

Introduction: The surgical resection of osteoid osteoma remains a technique of choice, for the treatment of this benign tumor. However, there are some anatomic localizations of the tumor (femoral neck, distal femur, spine, iliac bone), which are difficult to identify and to approach. The conventional techniques requires a large surgical exposure and the risk to fragilise the bone segment involved, being also present. The minimal invasive image guided technique, can offer an improved tumor location and surgical safety, for both patient and surgeon. The goal of this study is to clinicaly evaluate the minimal invasive, computer assisted technique, in the osteoid osteoma resection by using Fluoroscopy-based Navigation. Material and Methods : Five patients diagnosed with osteoid osteoma, underwent surgical resection, using Fluoroscopy-based Navigation. For the five cases, the lesion was put in evidence after performing conventional X Rays, scintigraphy and CT Scan. For the first two cases, the tumor was located in the posteromedial and the upper part region of the femoral neck. Tumor resection was done after conventional approach, intraoperative location and navigation using virtual fluoroscopy: with two intraoperative X ray views (AP and lateral), the lesion was identified, allowing surgical navigation in real time and minimal invasive, complete tumor resection. The procedure was exactly the same for the three other cases located in the distal part of the femur and the radius.