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Related Experiment Video

Updated: Jun 18, 2026

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
07:30

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery

Published on: May 4, 2022

Novel fluoroscopic technique for localization at cervicothoracic levels.

Harshpal Singh1, Scott A Meyer, Andrew C Hecht

  • 1Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY, USA.

Journal of Spinal Disorders & Techniques
|December 4, 2009
PubMed
Summary

A new oblique fluoroscopy technique accurately identifies spinal levels in the cervicothoracic region. This method overcomes challenges posed by shoulder shadowing, improving surgical accuracy for spinal procedures.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Radiology

Background:

  • Standard fluoroscopic views for cervicothoracic spine surgery are often obscured by shoulder and chest shadowing.
  • Obesity and muscular build can further degrade image quality, complicating spinal level localization.
  • Accurate intraoperative localization is crucial for preventing surgical errors.

Observation:

  • A modified oblique fluoroscopic view was developed to enhance visualization of the cervicothoracic spine.
  • This technique utilizes an oblique angle to remove shoulder and rib interference, creating a clearer image.
  • A distinct "target sign" is observed when the fluoroscope aligns with the lamina, aiding level identification.

Findings:

  • The modified oblique fluoroscopy technique successfully achieved correct spinal level identification in the distal cervical and proximal thoracic spine.
  • This novel method proved effective even in patients with challenging anatomy, such as large body mass index or significant musculature.
  • Postoperative imaging confirmed the accuracy of the intraoperative localization.

Implications:

  • This technique offers a safer and more reliable method for intraoperative spinal level localization in the cervicothoracic region.
  • It has the potential to reduce surgical errors and improve patient outcomes in spinal surgeries.
  • The modified oblique fluoroscopy technique is a valuable addition to the armamentarium for complex spinal procedures.