Bone Tumor Navigation in the Pelvis

Abstract

Pelvic and sacrum bones are highly complex in shape that is why they are one of the most challenging surgeries to achieve in oncologic orthopedics. Traditional resection and reconstruction are done “freehand” that is highly inaccurate. Conventionally, surgeons rely on twodimensional images from the pelvis. In this kind of surgeries it is achieved negative but also wide resections margins to be removed with a surrounding margin of healthy tissue so as to ensure the complete resection of the tumor. The complexity of pelvic surgeries relies on the size of the tumors that use to be huge, the difficulty to access, close proximity to vital structures and multiplanar complexity. It makes impossible to design onedesignfitsall prosthesis that is why this kind of surgeries overturn to computer assisted surgery and navigated guideline because it has identifiable bony prominences to use as reference points for resection. Preoperative navigation enables physicians to explore the tumor area before the operation and learn about the possible way outs of the resection. Intraoperative navigation simplifies surgeries reducing the risk of damaging vital structures and measure depth of penetration of the instruments, guiding the surgeon within the anatomical structures during the whole procedure. Although computer navigation assisted surgery in the Pelvis is in its relative infancy it is a useful asset that results on decreasing revision rate, decreasing need of amputation and saving nerves roots.