PMC7656041_01
(a) Sagittal T2-weighted, (b) axial T2-weighted, and (c) axial T1-weighted magnetic resonance imaging images demonstrating a T1-hypointense and T2-hyperintense cystic lesion located in the spinous process and right lamina of the L4 vertebra.
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F1
T2-hyperintense cystic lesion involving the right L4 spinous process and lamina (measuring 11 mm by 21 mm) [Figure 1].
Pre- (a and b) and postresection (c and d) intraoperative computed tomography scan demonstrating complete resection of a hypointense lesion located within the L4 spinous process and right lamina.
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F2
The differential diagnosis included osteoblastoma, giant cell tumor, and/or aneurysmal bone cyst. The patient underwent a fused iCT/MRI-guided resection of the right sided L4 lamina and removal of the L4 spinous process with a navigable ultrasound bone scalpel. The lesion was resected en bloc and the postresection CT scan confirmed gross total resection [Figures 2 and 3].
Intraoperative navigated computed tomography demonstrating stereotactic navigation being used to plan lateral extent of laminectomy bilaterally. The navigated stereotactic pointer used during the case is indicated in yellow.
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F3
The differential diagnosis included osteoblastoma, giant cell tumor, and/or aneurysmal bone cyst. The patient underwent a fused iCT/MRI-guided resection of the right sided L4 lamina and removal of the L4 spinous process with a navigable ultrasound bone scalpel. The lesion was resected en bloc and the postresection CT scan confirmed gross total resection [Figures 2 and 3].