Asian Spine J.  2016 Apr;10(2):360-365. 10.4184/asj.2016.10.2.360.

Utility of a Computed Tomography-Based Navigation System (O-Arm) for En Bloc Partial Vertebrectomy for Lung Cancer Adjacent to the Thoracic Spine: Technical Case Report

• Kobayashi
• Imagama S
• Ito Z
• Ando K
• Yokoi K
• Ishiguro N

• KMID: 2169246
• DOI: http://doi.org/10.4184/asj.2016.10.2.360

Abstract

We describe successful vertebrectomy from a posterior approach using a computed tomography (CT)-based navigation system (O-arm) in a 53-year-old man with adenocarcinoma of the posterior apex of the right lung with invasion of the adjacent rib, thoracic wall, and T2 and T3 vertebral bodies. En bloc partial vertebrectomy for lung cancer adjacent to the thoracic spine was planned using O-arm. First, laminectomy was performed from right T2 to T3, and pedicles and transverse processes of T2 to T3 were resected. O-arm was used to confirm the location of the cutting edge in the T2 to 3 right vertebral internal body, and osteotomy to the anterior cortex was performed with a chisel. Next, the patient was placed in a left decubitus position. The surgical specimen was extracted en bloc. This case shows that O-arm can be used reliably and easily in vertebrectomy from a posterior approach and can facilitate en bloc resection.

Keyword

Lung neoplasms; Computed tomography-based navigation system; En bloc partial vertebrectomy

MeSH Terms

Adenocarcinoma
Humans
Laminectomy
Lung Neoplasms*
Lung*
Middle Aged
Osteotomy
Ribs
Spine*
Thoracic Wall