Impact of Neuronavigation on Surgical Outcomes in Intra-axial Brain Lesions Resection: A Pilot Study in a Limited Resource Setting | ||||
| Pan Arab Journal of Neurosurgery | ||||
| Article 10, Volume 20, Issue 1, June 2025, Page 67-76 PDF (1.11 MB) | ||||
| Document Type: Original Articles | ||||
| DOI: 10.21608/pajn.2025.327356.1153 | ||||
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| Author | ||||
Mohammed Osama 
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| Neurological Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Neuronavigation (NNAV) is an essential neurosurgical tool, yet its cost often limits use in resource-limited settings. This pilot study reports our initial experience with NNAV in intra-axial brain lesion surgery. Objectives: To report our first formal use of NNAV and assess its impact on patient outcomes. Methodology: Sixteen adult patients with weakly or non-enhancing intra-axial lesions underwent NNAV-assisted surgery to optimize resection safety and radicality. We evaluated the surgeon's subjective experience and measured objective variables including Karnofsky Performance Status (KPS), Extent of Resection (EOR), complication rates, blood loss, and hospital stay. Statistical analyses were conducted to assess outcomes. Results: Surgeons reported positive experiences, highlighting improved accuracy in localizing challenging lesions and mitigating brain shift. The average EOR was 64.51%, with a gross total resection rate of 31.25%. Preoperative KPS averaged 86.25, improving to 91.25 postoperatively. The immediate post-surgery complication rate was 37.5%, remaining unchanged for three months. The average hospital stay was 5.69 days, and the mean blood loss was 387.50 ml. Strong positive correlations were found between preoperative KPS and both postoperative KPS (r = 0.735) and EOR (r = 0.794), suggesting that healthier patients achieved better outcomes. Tumors in opercular and temporal regions negatively impacted KPS change, and a gradual learning curve using the NNAV was observed. Conclusion: NNAV enhanced surgical precision, contributing to improved outcomes and reduced complications. Further research with larger samples is needed to confirm these findings and assess the long-term benefits of neuronavigation. | ||||
| Keywords | ||||
| Intra-axial brain tumor; resource-limited setting; extent of resection benefit; Karnofsky performance status scale (KPS); low-grade glioma surgery | ||||
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