PMC8177695_01
Timeline of case report.
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F1
3D-CT reconstruction images of the pelvis demonstrating the tumor and computer navigation-system utilized intra-operatively.
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F2
At this stage, navigation pins were inserted into the iliac crest and registration of important bony pelvic landmarks with the computer navigation system was confirmed (Stryker Navigation System with Spinemap 3D 3.1 software ) (Figure 2).
Intra-operative photos. (A) demonstration of the computer-navigated iliac crest resection with pubic cut overlay. (B) demonstration of iliac crest craft positioning. (C) iliac crest graft post resection. (D) Arrow demonstrating positioning of iliac crest graft in the resected pubis.
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F3
Using navigation, the planned osteotomies were created through bilateral superior and inferior pubic rami to mobilize the tumor (Figures 3A,B). Osteotomy of the iliac graft was then computer-navigated (Figure 3C). The iliac crest graft was prepared with drill holes and secured with Arthrex fiber wire sutures (Arthrex FiberTape 2 mm  ) to the adjacent pubic rami (Figure 3D).
(A) day 1 post surgery. 3D reconstructions of a CT pelvis demonstrating the iliac crest graft in-situ. (B) 6-month follow up X-Ray demonstrating stable positioning of the graft.
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F4
Post-operative scans demonstrated adequate positioning of the graft with no immediate complications (Figure 4). At 6-month follow-up there was no clinical or radiological evidence of tumor recurrence and she was able to ambulate independently (Figure 4).