Fig. 7
From: Neurosurgical emergencies in spinal tumors: pathophysiology and clinical management
Spinal laser interstitial thermal therapy (SLITT) for a metastatic spinal epidural tumor causing SCC. Real-time image guidance by a fiducial array attached percutaneously to a spinous process is used for accurate percutaneous laser probe placement (A). The process of SLITT starts with placement of Jamshidi needles that are registered to the intraoperative spinal navigation system, placed into plastic cannulas, and then imaged by intraoperative MRI to confirm the localization of each needle (B, C). The laser probe trajectory, which can be transpedicular or translaminar (D). Axial T2-weighted MRI showing a titanium needle artefact in the tumor. The coordinates are then maintained, and the titanium insert is replaced by a laser fiber (D)