PRESURGICAL MARKING WITH A NOVEL DEVICE IN NEUROSURGICAL OPERATIONS

Themistoklis K.1, Papasilekas T.1, Papadopoulos F.1, Psilovasilopoulos G.1, Karakalos S.1 , Panourias I.1, Arealis G.1

1. Department of Neurosurgery, “Korgialenio, Benakio, Hellenic Red Cross” General Hospital of Athens, Athens, Greece

Objective
To demonstrate a novel device used for pre-surgical planning in neurosurgical cases. Marking
the surgical level with this device is based on the principles of Euclidian trigonometry. .

Material-Method
The novel device is manufactured with 3 radiopaque thin, flat rods which are attached on an
adhesive patch. The aliment of the rods is forming two triangles, united in the middle. By
measuring the distance between the laterals and the middle rod spots, a unique horizontal
plane is defined, which corresponds only in these two parameters. The adhesive patch is
attached on the head or the back of the patient by approximation of the desired level. A pre
surgical CT scan or X-Ray is performed and the length between the rods is calculated above
the operative level. Then by measuring the exact same distance between the rods of the
attached device, the surgical level is marked on the patient’s skin and the device is removed.
Results
The device has been used in 25 intracranial and 10 spinal cases. The correct level was
marked with accuracy in all cases.

Conclusions
The novel device could be utilized for marking with accuracy the correct surgical level. It has
applications for both intracranial and spinal operations resulting in less overall operative time.