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Initial experience with intraoperative magnetic resonance imaging in spine surgery
E J Woodard1, S P Leon, T M Moriarty
1Department of Surgery, Division of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. ejwoodard@bics.bwh.harvard.edu
Spine
|February 27, 2001
Summary
Intraoperative MRI (IMRI) in spine surgery offers rapid, accurate patient localization and confirms decompression adequacy. This technology enhances surgical navigation and holds promise for tumor resection and screw fixation guidance.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Medical Imaging
Background:
- Current stereotactic navigation systems rely on pre-operative images, lacking real-time updates for intraoperative changes.
- Manual registration of anatomical landmarks to pre-operative images introduces potential errors in existing systems.
- Intraoperative Magnetic Resonance Imager (IMRI) provides real-time MRI imaging for surgical navigation, enabling image updates and frameless stereotaxy.
Purpose of the Study:
- To evaluate the advantages and limitations of IMRI in spine surgery.
- To explore potential applications of IMRI for enhancing surgical procedures.
- To assess the utility of intraoperative MRI for surgical guidance and confirmation.
Main Methods:
- A case series involving 12 patients undergoing spine surgery within an IMRI.
- Acquisition of T1- and T2-weighted fast spin echo images for localization and post-decompression assessment.
- Performance of various spinal procedures including discectomies, vertebrectomies, foraminotomies, and laminectomy within the IMRI environment.
Main Results:
- The IMRI system demonstrated rapid and accurate localization in all 12 surgical cases.
- The adequacy of surgical decompression was confirmed by intraoperative MRI in 10 out of 12 procedures.
- The open configuration of the IMRI allowed for complete surgeon access during the procedures.
Conclusions:
- IMRI provides accurate and timely localization during spine surgery.
- Intraoperative MRI effectively confirms the adequacy of decompression in most cases.
- Future applications include guidance for tumor resection and trajectory planning for spinal interventions.