Fluorescent techniques in spine surgery.

OBJECTIVES

The use of fluorescent compounds and techniques in neurosurgery has aided in delimitating tumor margins and visualizing blood dynamics in vascular malformations. However, the use of these techniques for the treatment of spinal lesions has not been well established.

METHODS

In this manuscript, we conduct a literature review to assess the role of fluorescent compounds in the treatment of vascular malformations and tumors of the spine. Other potential technologies such as activatable cell-penetrating peptides (ACPPs) and nanoparticles are also explored.

RESULTS

Several case reports and case series have described successful visualization and treatment of these lesions mainly with the aid of indocyanine green (ICG), with no complications reported. Nonetheless, no large-scale studies or prospective studies have been conducted.

DISCUSSION: Spinal lesions need to be adequately visualized intraoperatively to attain surgical success, and the use of fluorescent techniques may become a cornerstone in treating these lesions in the near future. Wide-scale applications and the potential use of other fluorophores such as 5-ALA and fluorescein should be further investigated.