Artikel
Computer navigation assisted surgery for musculoskeletal tumors
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Veröffentlicht: | 23. Oktober 2017 |
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Gliederung
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Objectives: Computer navigation assisted surgery for musculoskeletal tumors has been shown to reduce the risk of intralesional margins in resection.
Methods: We reviewed our first experiences in 24 patients (12 men and 12 women) with a mean age of 40 years (3 to 88) in whom computer navigation assisted surgery had been performed. There were 14 pelvic, 4 sacral and 6 extremity tumors, including osteosarcoma (9, 38%), chondrosarcoma (5, 21%), soft tissue sarcoma (5, 21%), Ewings sarcoma (3, 13%) and bone metastases (2, 8%).
Results and Conclusion: Applying surface matching, the primary registration error from referencing was reduced to <5mm in all cases. There were no complications related to navigation. One patient (4%) was evaluated to have a positive resection margin on the bony level after hemisacrectomy, however, had no sign of local recurrence. After a mean follow up of 15 months, three patients (13%) had died of disease and one of these patients also (4%) had suffered from a local recurrence after a pelvic tumor resection.
Computer navigation assisted surgery is safe and, especially in bone tumors with extensive soft tissue extension, has positively influenced the preoperative planning of resection levels in favor of acetabular joint sparing or limb sparing surgery. Consequently, we currently use navigation as a standard of care for pelvic sarcoma.