Figure 3.

Intraoperative stereotactic navigation can be used to determine the junction between the pathological osteophyte and the native anterior cortex and disc space, thereby ensuring complete but not overresection. Either of these 2 extremes is easily obtained without some measure of image guidance to ensure that the osteophyte is completely resected, whereas the native spinal column elements are preserved for stability. Image (A) demonstrates patients with anterior cervical syndesmophytes with significant compression on the esophagus at C3-4. The red line is the planned resection of osteophytes to remove esophageal compression without entering the disc space and destabilizing the cervical spine. Image (B) demonstrates resection of syndesmophytes after surgical resection using stereotactic navigation intraoperatively.