The role of computed tomography in the development and implementation of minimally invasive surgery methods in the clinic of bone pathology

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Abstract

The evaluation of the CT efficacy for the elaboration and realization of low invasive diagnosis and treatment in bone pathology was performed. Sixty two patients, aged from 6 to 80, were examined. The method of stereotaxic determination of pathologic locus localization with CT controlled manipulation (target biopsy, «anchor» navigation in disorder focus, injection of contrast matter and introduction of plastic materials into the focus) was used. The efficacy of those method made up 89.6% for target biopsy corresponding to the high degree accuracy of pathological process identification and 100%) for the preoperative marking. New elaborated method is accurate and safe for the patients.

 

About the authors

A. K. Morozov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

A. I. Snetkov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

A. V. Balberkin

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

A. A. Belyaeva

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

I. A. Kosov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

A. R. Frantov

Central Institute of Traumatology and Orthopedics. N.N. Priorova

Email: info@eco-vector.com
Russian Federation, Moscow

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2. Rice. 1. Patient D. Eosinophilic granuloma of the head of the right humerus. Target biopsy. a — calculation of the insertion point and angle of inclination of the trephine using radiopaque markers; b — control tomogram documenting the site of material sampling.

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3. Rice. 2. Patient G. Metastasis of vertebral T2 squamous cell carcinoma. Targeted biopsy under CT control using the developed device.

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4. Rice. 3. Patient B. Nonspecific chronic inflammatory process in the posterior part of the right iliac bone. Preoperative marking. and navigation "anchors" to the lesion; b — control examination after 14 months.

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5. Rice. 4. Patient G. Left-sided nonspecific sacroiliitis. a - therapeutic and diagnostic puncture; b — control examination after 2 months.

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6. Rice. 5. Patient B. Osteoid osteoma of the right talus. a - preoperative marking of the "nest" of the tumor; b — control examination 1.5 months after surgery

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7. Fig. 6. Patient K. Nonspecific inflammatory process in the bottom of the left acetabulum with the formation of an abscess in the small pelvis. a - diagnostic computer scan; b — injection of a contrast agent for the purpose of differential diagnosis.

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8. Rice. 7. Patient Ch. Intravertebral osteoid osteoma of the root of the right arch of the Tb vertebra. a — MPT: on T2 WI, a hyperintense signal from the posterior parts of the bodies and the posterior elements of the T5-7 vertebrae is determined; b — CT scan: “nest” of osteoid osteoma in the right sections of the arch of the Tb vertebra; c — navigation of the “anchor” into the “nest” of the osteoid osteoma; d — control examination after 8 months.

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