Utility of Preoperative Magnetic Resonance Imaging Coregistered with Intraoperative Computed Tomographic Scan for the Resection of Complex Tumors of the Spine.

Background: Complete surgical resection is known to provide the best prognosis when treating complex tumors of the spine. The anatomy of the cervical spine and the extensive involvement often present by the time these lesions are discovered can make total resection challenging. A novel technique combining preoperative and intraoperative imaging for intraoperative navigation can serve as an additional tool for facilitating tumor resection.

Methods: Preoperative MRI was coregistered with intraoperative CT for accurate, real-time, intraoperative navigation for complete resection of complex tumors of the cervical spine. This new technique is demonstrated. The potential advantages and challenges are discussed.

Results: Preoperative MRI coregistered and merged with intraoperative CT allows for accurate visualization of tumor boundaries, osseous anatomy, and surrounding soft tissue structures. Total resection of extensive spinal tumors involving the anterior and posterior elements can be facilitated with this technique.

Conclusions: Preoperative MRI coregistered and merged with intraoperative CT may serve as a useful intraoperative imaging modality for facilitating safe and complete resection of complex spine tumors.