To assess the efficacy of using intraoperative cone-beam O-arm computed tomography and navigation system in surgical treatment of the spine and spinal cord disorders. A total of 106 patients with degenerative spine diseases and spine and spinal cord tumors underwent surgery with O-arm iCT and navigation system from August 2013 to March 2014. The iCT system was used for tumors localized in anatomically hard-to-reach areas to control radicality of removal of bone tumors and those of the spinal cord with ossification, and for needle guidance in vertebroplasty. During stabilization stage the O-arm iCT and navigation system were used to control the accuracy of implant placement and to monitor decompression zones. The O-arm iCT with navigation system is particularly useful when surgery is performed in difficult anatomical conditions, and the use of two-dimensional images does not provide visualization of the surgical zone. Duration of the first surgeries using iCT and navigation system was longer, but within the first month there was a trend towards its shortening. Conclusions. Application of the O-arm iCT with navigation system in surgical treatment of spinal disorders provides high quality treatment, is safe for a patient, and allows for surgical intervention in difficult anatomical conditions.
Hemangioblastoma is a rare CNS vascular tumor that develops sporadically and can also be associated with von Hippel-Lindau disease. Hemangioblastomas account for 2-6% of all spinal cord tumors and are ranked third in the structure of intramedullary space-occupying lesions of the spinal cord. For the first time in our practice, we observed a dumbbell paravertebral hemangioblastoma. The international literature reports only 3 cases of the tumor with this growth type.
ОбзОры
История применения эндоскопической техники удаления грыж межпозвонковых дисков поясничного отдела позвоночникаПервое сообщение о возможности эндоскопии в спи-нальной хирургии сделано M. Burman [1], использовав-шим эндоскоп диаметром 9,5 мм для осмотра конского хвоста на трупах. Автор пришел к выводу, что техническое несовершенство оборудования не позволяет использовать эндоскопию в клинике, но прогнозировал возможность применения данного метода с целью уточнения диагноза.L. Pool [2] использовал модифицированный отоскоп с освещением для обследования корешков при грыже диска и при некоторых других видах патологии позвоночного канала. Впервые эндоскопическую биопсию ткани меж-
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