INTRODUCTION: The incidence of rare intradural @entity4097 is 3 to 10 per 100,000 of population. Open bilateral laminectomy with partial or total facet removal is the standard surgical access for gross total resection (GTR) of such @entity5 . Retrospective studies in adults revealed that for @entity1 operated with bilateral laminectomy as well with less invasive procedures, the risk of developing @entity86 or worsening @entity85 is still significant. The this study describes integration of Minimally invasive Spine Surgery (MISS) techniques with preoperative MRI data and intraoperative 3 dimensional fluoroscopic images with the aim of planning skin incision according to a precise transmuscular trajectory, thus tailoring @entity5 access with minimal bone resection in @entity1 with intradural extramedullary lesions. MATERIALS AND METHODS: A retrospective review of 45 consecutive surgical cases of @entity5 was carried out. Seven @entity1 operated for intradural extramedullary @entity5 using the image merged guided MISS were selected. Preoperative MRI and intraoperative 3D fluoroscopic data were manually merged using Synergy Cranial 2.2 software and Stealth Merge 1.2. Accuracy of manual image merging was verified with anatomic landmarks as references. After a 3D fluoroscopic image acquisition using the merged data, a skin incision was planned according to the chosen entry point and the transmuscular trajectory was optimised for @entity5 access. Under microscopic and neuronavigation guidance, tailored bone resection and lesion removal were carried out. RESULTS: From December 2012 to August 2014, we performed MISS removal of intradural extramedullary spine @entity5 in seven @entity1 , four male and three female as described above. Pre-operative Nurick score was 3 in three @entity1 , 1 in two @entity1 and 0 in other two cases. One @entity1 presented with local @entity1410 that regressed in the immediate postoperative period. Follow up ranges from 2 to 14months (average 5.8months). Follow up neurological Nurick scores recording reveals a favorable neurological outcome with a score of 0 in six @entity1 . Any @entity1 showed postoperative @entity16 . Only one @entity1 with a resected L1 @entity808 complains of postoperative @entity158 , which is responsive to medical treatment. MRI confirms GTR in all cases. CONCLUSION: The goal of treatment of intradural extramedullary lesions ismaximum @entity5 resection, adapting surgical approach to minimise manipulation of neural structures and reducing bone resection without comprising @entity5 resection. Image merged guided MISS is a safe and feasible procedure for @entity5 removal in @entity1 with intradural extramedullary @entity5 . In the present study, we demonstrate that this technique allows the surgeon to define entry point, to tailor transmuscular trajectory and @entity5 access while minimizing bone removal and achieving GTR of @entity75 .

Image merged guided spine surgery for XXXX : Retrospective series of 7 cases.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity808 :: ('MESH:D009442', 'Disease') :: ['Schwannoma'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'intradural tumors', 'tumors'] @entity75 :: ('MESH:D001927', 'Disease') :: ['intardural lesions'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological deterioration'] @entity1410 :: ('MESH:D006406', 'Disease') :: ['hematoma'] @entity86 :: ('MESH:D019106', 'Disease') :: ['postoperative deformity'] @entity158 :: ('MESH:D010146', 'Disease') :: ['radicular pain'] @entity4097 :: ('MESH:D013120', 'Disease') :: ['spinal cord tumors'] @entity85 :: ('MESH:D009140', 'Disease') :: ['preoperative deformity']
@entity5 :: (MESH:D009369,Disease) :: ['intradural tumors']
