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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:361-365, March 2003
© 2003 American Society of Neuroradiology

Technical Note
SPINE

Percutaneous Intraspinal Navigation: Feasibility Study of a New and Minimally Invasive Approach to the Spinal Cord and Brain in Cadavers

Phillip D. Purdy^a,b,c, Robert E. Replogle^a,b, G. Lee Pride, Jr^a, Christina Adams^c, Susan Miller^c and Duke Samson^b,c

^a Departments of Radiology, Division of Neuroradiology, the University of Texas Southwestern Medical Center at Dallas
^b Department of Neurological Surgery, the University of Texas Southwestern Medical Center at Dallas
^c Mobility Foundation Center, the University of Texas Southwestern Medical Center at Dallas

Address reprint requests to Phillip D. Purdy, MD, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8896

Summary: We describe a percutaneous approach for cerebral surgical access. After lumbar puncture, the spinal subarachnoid space was traversed by using standard angiographic guidewire techniques until the introducer catheters were in the intracranial space. Under fluoroscopic guidance, the intracranial subarachnoid space was navigated, and the ventricular system entered. Subarachnoid placement was confirmed with contrast-enhanced digital angiography. Placement anterior to the brain stem was confirmed in both cadavers during dissection, and spinal navigation without cord damage from the anterior or posterior approach was confirmed in one. Percutaneous intraspinal navigation is a new route of access for cerebrospinal surgery that has many potential applications.

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