Intraoperative three-dimensional navigation for surgical treatment of osteoid osteoma in the foot and ankle – A series of 14 cases

Intraoperative three-dimensional navigation for surgical treatment of osteoid osteoma in the upper extremity: A series of 19 cases

“…It also allowed operation room and surgical team setting which enables an open or mini open approach with dissection and protection of neurovascular structures. The navigated technique for the treatment of osteoid osteoma has been described in several publications in addition to ours, 15,19,23–25 and this is the first that is specific to the upper extremity. In a study by Ankory et al, our surgical technique was first described and published.…”

“…In this publication, as in two earlier publications on the application of our surgical method in multiple locations, we present our navigated approach to osteoid osteoma. 15,19 The navigated technique offered improved accuracy and provided measures to confirm the removal of the lesion during the procedure. It also allowed operation room and surgical team setting which enables an open or mini open approach with dissection and protection of neurovascular structures.…”

“…Another publication by Gurel et al presented the results of 14 patients with OO of the foot and ankle and also discussed the added value of the navigated technique in mini open curettage and complex anatomic locations. 19 Although CT guidance in ablation procedures of OO is a well-accepted and accurate method, 16,[26][27][28][29] the navigated technique offers a more flexible real-time stepwise approach to the exact location of the nidus in comparison to the CTguided technique in which multiple scans may sometimes be required until an accurate location is found and during which the surgical instruments may harm nearby structures. It also enables less radiation exposure to the surgical team.…”

“…It also enables less radiation exposure to the surgical team. 15 Finally, all of our reported procedures were performed by an orthopedic surgeon in an operating room setting, which enabled both closed manipulation for stiff joints as well as an additional open approach in some of the patients treated with NMRFA (patients 1, 2, 7, 9, 15,17,19) for the retraction of neurovascular structures away from the "destruction zone" of the RFA needle, when necessary, thereby increasing the safety of the procedure and enabling the performance of minimally invasive RFA in cases which otherwise would have required open curettage. Intralesional curettage was performed when the RFA approach was contraindicated due to the location of the OO being in close proximity to the skin, tendons, or neurovascular structures.…”

“…All operations were performed by a single surgeon according to a technique published by Ankory et al in 2019 and later by Gurel et al in 2022. 15,19 The patient was placed on a radiolucent, fluoroscopy-capable operating table, and the affected limb was prepared and draped in a sterile manner. The optical tracking array was secured to the patient either by silk sutures to the skin in proximity to the lesion or by bony anchor devices, depending upon the anatomical location of the lesion.…”