[Current Consensus and Challenges of Fluorescence Imaging Technology in the Surgery of Spinal Intramedullary Tumors]

Surgery for spinal intramedullary tumors remains a major challenge for neurosurgeons. Successful surgery requires experience, skill, and intraoperative imaging support. Fluorescence imaging technology has become a valuable support in neurosurgical procedures of not only the brain but also the spinal cord. Indocyanine green videoangiography(IVG-VA) is becoming popular for the qualitative assessment of blood flow dynamics during spinal intramedullary tumor surgery. IVG-VA can provide real-time information and help surgeons localize the normal circulation of the spinal cord as well as the feeding arteries and draining veins, particularly in highly vascular tumors. It can also be used for the objective quantitative evaluation of microvascular blood flow in the spinal cord parenchyma after tumor removal. Photodynamic diagnosis using 5-aminolevulinic acid(PDD) is an essential intraoperative imaging guide for brain glioma surgery. PDD has gradually been used in spinal intramedullary tumor surgery. However, some aspects of its usefulness must be verified. This chapter focuses on the current consensus and challenges in fluorescence imaging technology for spinal intramedullary tumor surgery.