Next Article in Journal
Acceptability and Palatability of Novel Orodispersible Minitablets of Enalapril in Children up to the Age of 6 with Heart Failure
Previous Article in Journal
A White Spot Around the Fissula Ante Fenestrum: A New Diagnostic Indicator for Otosclerosis
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
JCM
Volume 14
Issue 3
10.3390/jcm14030914
jcm-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Technical Note

Indocyanine Green as a Marker for Tissue Ischemia in Spinal Tumor Resections and Extended Revisions: A Technical Note

by
Max Ward
1,
Daniel Schneider
1,
Ethan D. L. Brown
1,
Apratim Maity
1,
Barnabas Obeng-Gyasi
2,
Roee Ber
1,
Aladine A. Elsamadicy
3,
Daniel M. Sciubba
1,
Denis Knobel
4 and
Sheng-Fu Larry Lo
1,*
1
Department of Neurological Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY 11549, USA
2
Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, USA
3
Department of Neurological Surgery, Yale School of Medicine, New Haven, CT 06510, USA
4
Department of Plastic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Lake Success, NY 11549, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(3), 914; https://doi.org/10.3390/jcm14030914
Submission received: 31 December 2024 / Revised: 19 January 2025 / Accepted: 28 January 2025 / Published: 30 January 2025
(This article belongs to the Special Issue Advancements in Spinal Oncology: The Current Landscape)
Versions Notes

Abstract

Background/Objectives: The increasing complexity of spinal oncology procedures, particularly in en-bloc tumor resections, creates challenges in tissue perfusion assessment due to extended operative times and extensive surgical dissection. Real-time visualization of tissue perfusion can be achieved with ICG using commercially available handheld imaging systems, offering potential advantages in spinal oncology cases. This study assessed the utility of ICG in analyzing soft-tissue viability during complex spine procedures extending beyond 7.5 h, with a particular focus on oncologic resections. Methods: Three cases that required over 7.5 h of operative time were chosen for ICG utilization. These cases included an en-bloc malignant peripheral nerve sheath tumor resection, an en-bloc resection of a malignant epithelioid neoplasm, and a long-segment fusion revision for pseudoarthrosis. At the conclusion of the critical portion of the procedure, a handheld intraoperative fluorescence camera was utilized to visualize the tissue penetration of intravenous ICG. Results: Prior to injecting ICG, devascularized tissue was not clearly visible. Injecting ICG allowed clear separation of vascularized (fluorescing) and devascularized (non-fluorescing) tissues. One region of non-florescent tissue was later confirmed to be devascularized with MRI and experienced postoperative infection. Conclusions: As the complexity of spinal oncology procedures increases, ICG fluorescence imaging offers a novel method for real-time assessment of tissue perfusion. This technique may be particularly valuable in extensive tumor resections, post-radiation cases, and revision surgeries where tissue viability is at risk. Further investigation in the spinal oncology population could help establish whether early identification of poorly perfused tissues impacts wound healing outcomes.
Keywords: indocyanine green (ICG); case series; perfusion; spine; spinal oncology; en-bloc resection indocyanine green (ICG); case series; perfusion; spine; spinal oncology; en-bloc resection

Share and Cite

MDPI and ACS Style

Ward, M.; Schneider, D.; Brown, E.D.L.; Maity, A.; Obeng-Gyasi, B.; Ber, R.; Elsamadicy, A.A.; Sciubba, D.M.; Knobel, D.; Lo, S.-F.L. Indocyanine Green as a Marker for Tissue Ischemia in Spinal Tumor Resections and Extended Revisions: A Technical Note. J. Clin. Med. 2025, 14, 914. https://doi.org/10.3390/jcm14030914

AMA Style

Ward M, Schneider D, Brown EDL, Maity A, Obeng-Gyasi B, Ber R, Elsamadicy AA, Sciubba DM, Knobel D, Lo S-FL. Indocyanine Green as a Marker for Tissue Ischemia in Spinal Tumor Resections and Extended Revisions: A Technical Note. Journal of Clinical Medicine. 2025; 14(3):914. https://doi.org/10.3390/jcm14030914

Chicago/Turabian Style

Ward, Max, Daniel Schneider, Ethan D. L. Brown, Apratim Maity, Barnabas Obeng-Gyasi, Roee Ber, Aladine A. Elsamadicy, Daniel M. Sciubba, Denis Knobel, and Sheng-Fu Larry Lo. 2025. "Indocyanine Green as a Marker for Tissue Ischemia in Spinal Tumor Resections and Extended Revisions: A Technical Note" Journal of Clinical Medicine 14, no. 3: 914. https://doi.org/10.3390/jcm14030914

APA Style

Ward, M., Schneider, D., Brown, E. D. L., Maity, A., Obeng-Gyasi, B., Ber, R., Elsamadicy, A. A., Sciubba, D. M., Knobel, D., & Lo, S.-F. L. (2025). Indocyanine Green as a Marker for Tissue Ischemia in Spinal Tumor Resections and Extended Revisions: A Technical Note. Journal of Clinical Medicine, 14(3), 914. https://doi.org/10.3390/jcm14030914

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

Article Metrics

Back to TopTop