Navigation-assisted surgery for bone and soft tissue tumors with bony extension

Area of Science:

• Orthopaedic Surgery
• Surgical Oncology
• Medical Navigation Technology

Background:

• Navigation systems have been utilized in orthopaedic surgery since the 1990s.
• Computed tomography (CT)-based navigation systems are increasingly employed in spinal and joint replacement surgeries due to their enhanced precision.

Purpose of the Study:

• To assess the accuracy and effectiveness of navigation-assisted surgical techniques for the removal of bone and soft tissue tumors.

Main Methods:

• A study involving 16 patients (11 male, 5 female; mean age 39 years) undergoing navigation-assisted tumor excision between 2006 and 2009.
• Procedures included nine excisional biopsies for benign tumors and seven en bloc excisions for malignant tumors, with some soft tissue tumors invading adjacent bone.
• A point registration method using 10 skin markers was employed, and accuracy was evaluated by comparing preoperative and postoperative plans via histology or CT scans.

Main Results:

• The navigation system achieved a mean accuracy of 0.93 mm (range, 0.6-1.2 mm) when assessed using skin markers.
• Pathologic examination and postoperative CT imaging confirmed minimal differences (0-4 mm) between planned margins and excised specimens.
• Follow-up averaged 34 months, with no local recurrences observed, except in one case of skip metastases from a chordoma.

Conclusions:

• Navigation-assisted surgery proves to be a reliable and accurate method for minimally invasive resection of bone and soft tissue tumors.
• The technique is indicated for achieving precise tumor removal in orthopaedic oncology.