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. 2018 Jan-Feb;52(1):22-30.
doi: 10.4103/ortho.IJOrtho_205_17.

Navigation in Musculoskeletal Oncology: An Overview

Guy Vernon Morris  1 , Jonathan D Stevenson  1 , Scott Evans  1 , Michael C Parry  1 , Lee Jeys  1   2
Affiliations

Navigation in Musculoskeletal Oncology: An Overview

Guy Vernon Morris et al. Indian J Orthop. 2018 Jan-Feb.

Abstract

Navigation in surgery has increasingly become more commonplace. The use of this technological advancement has enabled ever more complex and detailed surgery to be performed to the benefit of surgeons and patients alike. This is particularly so when applying the use of navigation within the field of orthopedic oncology. The developments in computer processing power coupled with the improvements in scanning technologies have permitted the incorporation of navigational procedures into day-to-day practice. A comprehensive search of PubMed using the search terms "navigation", "orthopaedic" and "oncology" yielded 97 results. After filtering for English language papers, excluding spinal surgery and review articles, this resulted in 38 clinical studies and case reports. These were analyzed in detail by the authors (GM and JS) and the most relevant papers reviewed. We have sought to provide an overview of the main types of navigation systems currently available within orthopedic oncology and to assess some of the evidence behind its use.

Keywords: Computer-assisted tumor surgery; Tumors; computer assisted decision making; magnetic resonance imaging; musculoskeletal tumors; navigation; pelvis.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Preoperative resection templating on navigation software
Figure 2
Figure 2
Color coded preoperative planning of resections (green and purple) with tumor (yellow) and computer aided design implant (red)
Figure 3
Figure 3
Intra-operative photograph demonstrating display screen and navigated probe and osteotome
Figure 4
Figure 4
Intra-operative photograph demonstrating display screen and navigated probe and osteotome
Figure 5
Figure 5
Resection specimen and computer-aided design implant
Figure 6
Figure 6
Navigation and computer-aided design production allows higher degree of anatomical conformity between resection and implant
Figure 7
Figure 7
Postoperative radiograph of pelvis with both hips anteroposterior view showing implant in situ
Figure 8
Figure 8
Radiograph of pelvis with both hip joints anteroposterior view showing lytic lesion in left acetabulum
Figure 9
Figure 9
Magnetic resonance imaging sagittal cut showing extent of tumor mass
Figure 10
Figure 10
Postoperative radiograph of pelvis with both hip joints anteroposterior view showing insertion of custom implant following tumor resection
Figure 11
Figure 11
Radiograph of pelvis with both hip joints anteroposterior view showing large pelvic chondrosarcoma
Figure 12
Figure 12
Magnetic resonance imaging scanning revealing extent of tumor spread
Figure 13
Figure 13
Magnetic resonance imaging showing sciatic notch involvement
Figure 14
Figure 14
Postoperative radiograph of pelvis with both hip joints following navigated internal hemi-pelvectomy with irradiation and re-implantation
See this image and copyright information in PMC

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