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The combination of semi-sitting position and intraoperative MRI—first report on feasibility

Acta Neurochirurgica volume 152, pages 947–951 (2010)Cite this article

Abstract

Introduction

Intraoperative MRI (iMRI) has been established as a routine imaging modality with a remarkable impact on specific neurosurgical procedures. The technological advancement continuously extends the spectrum of iMRI, leading to an increasing number of installations. Yet, procedures in which a semi-sitting position would be advantageous were beyond the reach of iMRI.

Materials and methods

We performed an iMRI-guided surgical procedure in a patient with a cystic lesion of the inferior parieto-occipital lobe while the patient was placed in a semi-sitting position, employing a mobile 0.15-T intraoperative MRI system. For that purpose, we adapted a standard OR table according to the needs of iMRI.

Findings

Patient positioning could be accomplished easily. For intraoperative scanning, the OR table was tilted backwards so as to position the patient’s head in the magnet’s aperture. Obtained images were used for neuronavigated cyst evacuation via burr hole trephination after repositioning the OR table. Subsequent intraoperative imaging documented collapse of the cyst at the end of the procedure. There were no adverse effects resulting from the combination of semi-sitting position and iMRI guidance.

Conclusion

This report demonstrates for the first time that the combination of iMRI and the semi-sitting position is feasible and that this procedure bears specific benefits. Issues such as brain shift due to table tilting warrant further investigations in order to expand this technique to posterior fossa craniotomies.

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Conflict of interest statement

The corresponding author is a member of the scientific advisory board of Medtronic Navigation Technology. Yet, the company did not provide any financial support to this study. All other authors have no potential conflict of interests.

Author information

Affiliations

  1. Department of Neurosurgery, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany

    Thomas Gasser

  2. Department of Neurosurgery, Goethe University, Frankfurt/Main, Germany

    Thomas Gasser, Christian Senft, Julian Rathert, Rüdiger Gerlach & Volker Seifert

  3. Department of Anesthesiology, Goethe University, Frankfurt/Main, Germany

    Karin Friedrich

  4. Institute of Neuroradiology, Goethe University, Frankfurt/Main, Germany

    Elke Hattingen

Authors
  1. Thomas Gasser
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  2. Christian Senft
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  3. Julian Rathert
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  4. Karin Friedrich
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  5. Elke Hattingen
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  6. Rüdiger Gerlach
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  7. Volker Seifert
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Corresponding author

Correspondence to Thomas Gasser.

Additional information

Thomas Gasser and Christian Senft contributed equally to this manuscript.

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Gasser, T., Senft, C., Rathert, J. et al. The combination of semi-sitting position and intraoperative MRI—first report on feasibility. Acta Neurochir 152, 947–951 (2010). https://doi.org/10.1007/s00701-010-0607-8

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  • DOI: https://doi.org/10.1007/s00701-010-0607-8

Keywords

  • Intraoperative MRI
  • Semi-sitting position
  • Surgical techniques