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Multidisciplinary Surgical Approach Using Augmented Reality Preplanning for Resection of Giant Thoracic Schwannoma
Adam C Monek1, Rida Mitha1, Edward Andrews1,2
1Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh , Pennsylvania , USA.
Operative Neurosurgery (Hagerstown, Md.)
|April 30, 2024
Summary
A dual surgeon approach, augmented reality, and robotic techniques can mitigate risks associated with resecting large thoracic spinal cord tumors. This strategy improved outcomes for a patient with a complex nerve sheath tumor.
Area of Science:
- Neurosurgery
- Spinal Oncology
Background:
- Primary spinal cord tumors represent 5% of central nervous system tumors in adults.
- Schwannomas constitute 74% of nerve sheath tumors, with thoracic schwannomas posing neurovascular risks.
- Complex spinal tumors necessitate advanced surgical strategies for safe resection.
Observation:
- A 73-year-old female presented with severe thoracic pain and falls due to a rapidly growing T3-T5 nerve sheath tumor.
- Augmented reality volumetric rendering aided perioperative planning for the large thoracic dumbbell tumor.
- A dual surgeon approach, combining video-assisted thoracoscopic surgery with robotic assistance and posterior resection, was employed.
Findings:
- Complete resection of the large thoracic dumbbell tumor was achieved.
- The patient experienced a positive postoperative recovery.
- The integrated surgical approach effectively managed the complex spinal pathology.
Implications:
- Augmented reality and advanced robotic techniques enhance perioperative evaluation and surgical precision.
- A dual surgeon strategy is crucial for optimizing outcomes in challenging spinal tumor resections.
- This multidisciplinary approach offers a viable solution for complex thoracic spinal schwannomas.
