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Related Experiment Video

Updated: Jun 10, 2025

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Minimal Invasive Pre-Op CT-Guided Gold-Fiducials in Local Anesthesia for Easy Level Localization in Thoracic Spine

Fee Keil1, Frank Hagemes2, Matthias Setzer2

  • 1Institute of Neuroradiology, University hospital Frankfurt, 60528 Frankfurt am Main, Germany.

Journal of Clinical Medicine
|October 16, 2024
PubMed
Summary
This summary is machine-generated.

Preoperative placement of gold fiducial markers using CT guidance is a safe and efficient method for identifying thoracic spine levels during surgery. This minimally invasive technique, performed under local anesthesia, ensures accurate intraoperative localization with minimal patient discomfort.

Keywords:
CT-guided fiducial placementintraoperative level localizationlocal anesthesia markersminimal invasivepreoperative spinal procedures

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Area of Science:

  • Neurosurgery
  • Radiology
  • Spinal Surgery

Background:

  • Accurate intraoperative level identification is critical in thoracic spine surgery, especially with patient obesity or anatomical variations.
  • Preoperative percutaneous fiducial marker placement under local anesthesia was investigated for safety and efficiency.

Purpose of the Study:

  • To evaluate the safety and efficiency of preoperative percutaneous gold fiducial marker placement for thoracic spine surgery.
  • To assess the feasibility of performing this procedure under local anesthesia with minimal patient discomfort.

Main Methods:

  • Retrospective analysis of 10 patients undergoing CT-guided gold fiducial placement prior to thoracic intraspinal lesion surgery (June 2019-June 2020).
  • Procedures performed 2-48 hours preoperatively under local anesthesia alone.
  • Data collected included patient characteristics, CT intervention time, and perioperative complications.

Main Results:

  • Gold markers were successfully placed under local anesthesia and visualized intraoperatively via fluoroscopy in all cases.
  • No preoperative marker dislocation or malposition occurred; the procedure was radiation-free for the interventionalist.
  • Average CT intervention time was 14.3 minutes; 20% of patients had anatomical variants (sacralization).

Conclusions:

  • CT-guided transcutaneous submuscular gold marker placement under local anesthesia is a safe, practical, and minimally invasive method for thoracic spine surgery.
  • This technique allows for rapid and accurate intraoperative level determination, offering a time-saving approach.
  • The procedure is virtually painless and can be performed on an outpatient or inpatient basis.