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Intraoperative Computed Tomography Scanner-Guided Junctional Zone Spinal Surgery in Fluoroscopic Limitation Zone-An Early Experience

Author(s)
Usman Ahmad Kamboh Departments of,,Neurosurgery,Allama Iqbal Medical College, Jinnah Hospital Lahore Pakistan
Adeel Rauf Departments of,,Neurosurgery,Allama Iqbal Medical College, Jinnah Hospital Lahore Pakistan
Muhammad Usama Saleem Departments of,,Neurosurgery,Allama Iqbal Medical College, Jinnah Hospital Lahore Pakistan
Mehreen Mehboob Departments of,,Neurosurgery,Allama Iqbal Medical College, Jinnah Hospital Lahore Pakistan
Mehwish Manzoor Department of Oncology, Allama Iqbal Medical College, Jinnah Hospital Lahore Pakistan
Sana Jamal Departments of,,Neurosurgery,Allama Iqbal Medical College, Jinnah Hospital Lahore Pakistan
Manzoor Ahmad Departments of,,Neurosurgery,Allama Iqbal Medical College, Jinnah Hospital Lahore Pakistan
Abstract
Objective: Confirmation of the level for surgery at the junctional zones of the spine is associated with unique difficulties. C-Arm has its limitations in these areas. The use of intraoperative CT scan with navigation greatly helps in the surgery at junctional zones. These junctional zones include the craniocervical junction, cervicodorsal junction, and sacroiliac junction. In 2019, we installed an Airo Brain Lab 32-slice MDCT in our facility and researched to evaluate its advantages in junctional zone fluoroscopy-restricted spine operations. Material and Methods: We performed 20 complex surgeries in all these 3 junctional zones with the use of an intraoperative computed tomography scanner. 3 patients had craniovertebral junction fixation under intra-op CT while 6 had lateral mass fixation. 3 patients had cervicodorsal junction fixation and 4 patients had lumbosacral fixation. Results: 2 out of 3patients with cervicodorsal fixation had correction of screws trajectory after usage of intraop CT and 1 patient with lumbosacral fixation. All patients were discharged home with neurology better or the same as compared to pre-op. status while 13 patients had a favorable outcome. Conclusion: Intraoperative computed tomography scanner is opening new horizons for complex spinal surgeries.
Publication Details
Page(s) 86-92
DOI 10.36552/pjns.v27i1.845
Published Journal: Pakistan Journal of Neurological Surgery, Volume: 27, Issue: 1, Year: 2023

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Keywords
craniovertebral junction surgery, Intraoperative CT scanner, Junctional Zone Surgery, Type 2 Odontoid Fracture
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