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Fluorescent techniques in spine surgery
Objectives:
The use of fluorescent compounds and techniques in neurosurgery has aided in delimitating tumor margins and visualizing blood dynamics in vascular malformations. However, the use of these techniques for the treatment of spinal lesions has not been well established.
Methods:
In this manuscript, we conduct a literature review to assess the role of fluorescent compounds in the treatment of vascular malformations and tumors of the spine. Other potential technologies such as activatable cell-penetrating peptides (ACPPs) and nanoparticles are also explored.
Results:
Several case reports and case series have described successful visualization and treatment of these lesions mainly with the aid of indocyanine green (ICG), with no complications reported. Nonetheless, no large-scale studies or prospective studies have been conducted.
Discussion:
Spinal lesions need to be adequately visualized intraoperatively to attain surgical success, and the use of fluorescent techniques may become a cornerstone in treating these lesions in the near future. Wide-scale applications and the potential use of other fluorophores such as 5-ALA and fluorescein should be further investigated.
Insights
Fluorescent techniques show promise for spinal lesion treatment, aiding visualization and tumor margin delineation. Further research is needed to establish wide-scale applications for these innovative neurosurgical methods.
Area of Science:
- Neurosurgery
- Oncology
- Medical Imaging
Background:
- Fluorescent compounds enhance tumor margin delineation and blood flow visualization in neurosurgery.
- Current applications of fluorescence in spinal lesion treatment are not well-established.
Purpose of the Study:
- To review the role of fluorescent compounds in treating spinal vascular malformations and tumors.
- To explore emerging technologies like activatable cell-penetrating peptides (ACPPs) and nanoparticles for spinal lesion treatment.
Main Methods:
- Literature review of case reports and series.
- Assessment of fluorescent techniques, including indocyanine green (ICG).
- Exploration of novel technologies such as ACPPs and nanoparticles.
Main Results:
- Case reports indicate successful visualization and treatment of spinal lesions using ICG, with no reported complications.
- Limited evidence exists, with a lack of large-scale or prospective studies.
Conclusions:
- Effective intraoperative visualization is crucial for successful spinal lesion surgery.
- Fluorescent techniques hold potential as a cornerstone for treating spinal lesions.
- Further investigation into wide-scale applications and alternative fluorophores like 5-ALA and fluorescein is recommended.
