J Neurol Surg A Cent Eur Neurosurg 2014; 75(06): 415-421
DOI: 10.1055/s-0034-1368690
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Video-Assisted Thoracoscopic Surgery under O-Arm Navigation System Guidance for the Treatment of Thoracic Disk Herniations: Surgical Techniques and Early Clinical Results

Jung-Woo Hur
1   Department of Neurosurgery, Seoul St. Mary's Hospital, Seoul, Korea
Jin-Sung Kim
1   Department of Neurosurgery, Seoul St. Mary's Hospital, Seoul, Korea
Dong-Young Cho
1   Department of Neurosurgery, Seoul St. Mary's Hospital, Seoul, Korea
Jong-Mok Shin
2   Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea
Jun-Ho Lee
2   Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea
Sang-Ho Lee
2   Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea
› Author Affiliations
Further Information

Publication History

26 March 2013

10 December 2013

Publication Date:
25 February 2014 (online)


This study describes the surgical technique and clinical results of video-assisted thoracoscopic surgery (VATS) assisted by an O-arm-based navigation system, used for the treatment of thoracic disk herniation (TDH). The trend toward the use of minimally invasive procedures with endoscopic visualization of the thoracic cavity in thoracic spine surgery has evolved. It is difficult to develop a new set of visuomotor skills unique to endoscopic procedures and understand the three-dimensional (3D) anatomy while performing a two-dimensional (2D) imaging procedure. Adding image guidance would have a positive impact on these procedures, making them safer and more precise. We report the results of 10 patients who underwent diskectomy for TDH using VATS assisted by an O-arm-based navigation system and describe the surgical technique. The average duration of the symptoms was 2.8 years; average operation time, 326.9 minutes; and average additional time required for the image guidance surgery using the O-arm-based navigation, ∼ 29.4 minutes. No complications occurred during the surgical procedure or the immediate postoperative period. The advantages of using navigational assistance during the surgical procedure include better visualization of the operative field, more accurate surgical planning, and optimization of the surgical approach involving the establishment of the correct drilling trajectory and safe decompression of the spinal cord, as well as the possibility of intraoperative control of bone resection.

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