Can computer navigation-assisted surgery reduce the risk of an intralesional margin and reduce the rate of local recurrence in patients with a tumour of the pelvis or sacrum?

Bone and Joint Journal - Tập 95-B Số 10 - Trang 1417-1424 - 2013
Lee Jeys1, Gulraj S. Matharu1, Rajpal Nandra1, R. J. Grimer1
1The Royal Orthopaedic Hospital, Birmingham B31 2AP, UK.

Tóm tắt

We hypothesised that the use of computer navigation-assisted surgery for pelvic and sacral tumours would reduce the risk of an intralesional margin. We reviewed 31 patients (18 men and 13 women) with a mean age of 52.9 years (13.5 to 77.2) in whom computer navigation-assisted surgery had been carried out for a bone tumour of the pelvis or sacrum. There were 23 primary malignant bone tumours, four metastatic tumours and four locally advanced primary tumours of the rectum. The registration error when using computer navigation was <  1 mm in each case. There were no complications related to the navigation, which allowed the preservation of sacral nerve roots (n = 13), resection of otherwise inoperable disease (n = 4) and the avoidance of hindquarter amputation (n = 3). The intralesional resection rate for primary tumours of the pelvis and sacrum was 8.7% (n = 2): clear bone resection margins were achieved in all cases. At a mean follow-up of 13.1 months (3 to 34) three patients (13%) had developed a local recurrence. The mean time alive from diagnosis was 16.8 months (4 to 48). Computer navigation-assisted surgery is safe and has reduced our intralesional resection rate for primary tumours of the pelvis and sacrum. We recommend this technique as being worthy of further consideration for this group of patients. Cite this article: Bone Joint J 2013;95-B:1417–24.

Từ khóa


Tài liệu tham khảo

10.1302/0301-620X.89B7.19067

10.1080/17453670810016731

10.1200/JCO.2003.01.142

10.1007/s11999-008-0495-x

Jeys L, 2012, J Bone Joint Surg [Br], 94, 39, 10.2106/JBJS.L.00194

10.1097/00007632-200003010-00012

10.1016/j.injury.2004.05.011

10.1016/j.arth.2005.05.009

10.1002/jso.21267

10.1007/s11999-010-1465-7

10.1007/s11999-011-2094-5

10.1007/s11999-012-2536-8

10.2106/00004623-197860060-00002

10.1302/0301-620X.93B5.25608

10.1302/0301-620X.94B10.28638

10.1007/s11999-012-2557-3

10.1007/s11999-008-0374-5

Fuchs B, 2005, J Bone Joint Surg [Am], 87, 2211

10.1097/BRS.0b013e3181b61b90

10.1097/BRS.0b013e3181bad11d