Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

Abstract Background The three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of far-lateral approach. This study was designed to disclose the relationship between surgical space and exposed tissues in the far-lateral approach by the volumetric analysis of 3D model. Methods The 3D skull base models were constructed using MRI and CT data of 15 patients (30 sides) with trigeminal neuralgia. Surgical corridors of the far-lateral approach were simulated by triangular pyramids to represent two surgical spaces exposing bony and neurovascular tissues. Volumetric comparison of surgical anatomy was performed using pair t test. Results The morphometric results were almost the same in the two surgical spaces except the vagus nerve (CN X) exposed only in one corridor, whereas the volumetric comparison represented the statistical significant differences of surgical space and bony and neurovascular tissues involved in the two corridors (P<0.001). The differences of bony and neurovascular tissues failed to equal the difference of surgical space. Conclusions For far-lateral approach, the increase of exposure for the bony and neurovascular tissues is not necessarily matched with the increase of surgical space. The volumetric comparative analysis is helpful to provide more detailed anatomical information in the surgical design.

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Volumetric Comparative Analysis of Anatomy Through Far-Lateral Approach: Surgical Space and Exposed Tissues

10.21203/rs.3.rs-307279/v1 ◽

2021 ◽

Author(s):

Ke Tang ◽

Xu Feng ◽

Xiaodong Yuan ◽

Yang Li ◽

Xinyue Chen

Keyword(s):

Comparative Analysis ◽

3D Visualization ◽

Three Dimensional ◽

Volumetric Analysis ◽

Lateral Approach ◽

Surgical Anatomy ◽

Far Lateral Approach ◽

Far Lateral ◽

The Difference ◽

Ct Data

Abstract Objective The three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of far-lateral approach. This study was designed to disclose the relationship between surgical space and exposed tissues in the far-lateral approach by the volumetric analysis of 3D model. Methods The 3D skull base modelswere constructed using MRI and CT data of 15 patients (30 sides) with trigeminal neuralgia. Surgical corridorsof the far-lateral approach was simulated by triangular pyramids to represent two surgical spaces exposing bony and neurovascular tissues. Volumetric comparison of surgical anatomy was performed using pair t test. Results The morphometric results were almost the same in the two surgical spaces except the vagus nerve (CN X) exposed only in one corridor. Whereas, the volumetric comparison represented the statistical significant differences of surgical space, and bony and neurovascular tissues involved in the two corridors (P༜0.001). The differences of bony and neurovascular tissuesfailed to equal the difference of surgical space. Conclusions For far-laterl approach, the increase of exposure for the bony and neurovascular tissues is not necessarilymatched with the increase of surgical space. The volumetric comparative analysis is helpful to provide more detailed anatomical information in the surgical design.

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Volumetric comparative analysis of anatomy through far-lateral approach: surgical space and exposed tissues

10.21203/rs.3.rs-307279/v2 ◽

2021 ◽

Author(s):

Ke Tang ◽

Feng Xu ◽

Xiaodong Yuan ◽

Yang Li ◽

Xinyue Chen

Keyword(s):

Comparative Analysis ◽

3D Visualization ◽

Three Dimensional ◽

Volumetric Analysis ◽

Lateral Approach ◽

Surgical Anatomy ◽

Far Lateral Approach ◽

Far Lateral ◽

The Difference ◽

Ct Data

Abstract Background The three-dimensional (3D) visualization model has ability to quantify the surgical anatomy of far-lateral approach. This study was designed to disclose the relationship between surgical space and exposed tissues in the far-lateral approach by the volumetric analysis of 3D model. Methods The 3D skull base models were constructed using MRI and CT data of 15 patients (30 sides) with trigeminal neuralgia. Surgical corridors of the far-lateral approach was simulated by triangular pyramids to represent two surgical spaces exposing bony and neurovascular tissues. Volumetric comparison of surgical anatomy was performed using pair t test. Results The morphometric results were almost the same in the two surgical spaces except the vagus nerve (CN X) exposed only in one corridor. Whereas, the volumetric comparison represented the statistical significant differences of surgical space, and bony and neurovascular tissues involved in the two corridors (P༜0.001). The differences of bony and neurovascular tissuesfailed to equal the difference of surgical space. Conclusions For far-laterl approach, the increase of exposure for the bony and neurovascular tissues is not necessarilymatched with the increase of surgical space. The volumetric comparative analysis is helpful to provide more detailed anatomical information in the surgical design.

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The Three-Dimensional Endoscopic Far-Lateral Approach: Many Dimensions to the Craniocervical Junction with a Far-From-Average Operation

World Neurosurgery ◽

10.1016/j.wneu.2014.06.039 ◽

2014 ◽

Vol 82 (6) ◽

pp. e709-e710 ◽

Cited By ~ 1

Author(s):

Mohamad Bydon ◽

Ziya L. Gokaslan

Keyword(s):

Three Dimensional ◽

Craniocervical Junction ◽

Lateral Approach ◽

Far Lateral Approach ◽

Far Lateral

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Far lateral approach for microsurgical ligation of C1 dural arteriovenous fistula: surgical anatomy and technical nuances

Neurosurgical FOCUS ◽

10.3171/2019.2.focusvid.18697 ◽

2019 ◽

Vol 46 (Suppl_2) ◽

pp. V6

Author(s):

Varun R. Kshettry ◽

Nina Z. Moore ◽

Mark Bain

Keyword(s):

Spinal Cord ◽

Arteriovenous Fistula ◽

Dural Arteriovenous Fistula ◽

Venous Drainage ◽

Lateral Approach ◽

Surgical Anatomy ◽

Drainage Pattern ◽

Mr Image ◽

Far Lateral Approach ◽

Far Lateral

This video demonstrates the diagnosis and surgical ligation of a C1 dural arteriovenous fistula via a far lateral, transcondylar approach. The patient’s dural arteriovenous fistula was identified by MRI signal changes in the spinal cord and a cerebrospinal angiogram demonstrating an abnormal hypertrophied early venous drainage pattern suggestive of a C1 vessel origin. Indocyanine green was used to verify surgical treatment of the fistula intraoperatively. A postoperative angiogram and MR image demonstrate fistula occlusion and resolution of the spinal cord edema. Anatomic details and technical nuances of the approach are demonstrated.The video can be found here: https://youtu.be/zSd0vuov8xk.

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