Individualized treatment of XXXX guided by intraoperative computed tomography.

@entity1 @entity154 @entity600 @entity51 @entity531
STUDY DESIGN: This study was designed to report our preliminary experience of intraoperative computed tomography (iCT) using a mobile scanner with integrated neuronavigation system (NNS). OBJECTIVE: The objective of this study was to assess the feasibility and potential utility of iCT with integrated NNS in individualized treatment of @entity600 ( @entity600 ). SUMMARY OF BACKGROUND DATA: The surgical management of @entity154 is complex due to the relative difficulty in accessing the region, critical relationships of @entity531 , and the intricate biomechanical issues involved. METHODS: We reported our first 19 complex @entity600 cases including 11 male and 8 female @entity1 from January, 2009 to June, 2009 (mean age, 33.9 y; age range, 13 to 58 y). A sliding gantry 40-slice CT scanner was installed in a preexisting operating room. Image data was transferred directly from the scanner into the NNS using an automated registration system. We applied this technology to transoral odontoidectomy in 17 @entity1 . Moreover, with the extra help of iCT integrated with NNS, odontoidectomy through posterior midline approach, and transoral atlantal lateral mass resection were, for the first time, performed for treatment of complex @entity600 . RESULTS: NNS was found to correlate well with the intraoperative findings, and the recalibration was uneven in all cases with an accuracy of 1.6 mm (1.6: 1.2 to 2.0). All @entity1 were clinically evaluated by Nurick grade criteria, and @entity51 were monitored after 3 months of surgery. Fifteen @entity1 (79%) were improved by at least 1 Nurick grade, whereas the grade did not change in 4 @entity1 (21%). CONCLUSIONS: iCT scanning with integrated NNS was both feasible and beneficial for the surgical management of complex @entity600 . In this unusual @entity1 population, the technique seemed to be valuable in negotiating complex anatomy and achieving a safe and predictable decompression.
