描述一种新颖、实用、可重复且有效的术前标记技术，用于对一系列肿瘤病变患者的脊柱水平进行精确定位。我们回顾性分析了 2016 年至 2021 年接受脊柱肿瘤微创 (MIS) 手术的患者，使用了这种标记技术。纳入的 21 名患者的肿瘤病变涉及 X 光镜观察困难（颈胸交界处或上背脊柱，C6-T8）。所有病例的肿瘤病变水平均事先通过增强 MRI 确定。手术前 24 至 48 小时，通过使用类似于 MIS 方法计划轨迹放置的 21 号针注入碳水悬浮液来进行计算机断层扫描图像引导碳标记。在手术过程中，跟踪活性炭标记，直到到达骨头上的最终目标。接下来，放置顺序扩张器和 MIS 牵开器。然后根据情况进行骨切除和肿瘤切除术。平均年龄60.6岁（26-76岁）。十五名 (71%) 患者是女性。在大多数情况下（76%），肿瘤病理涉及硬膜内病变（脑膜瘤和神经鞘瘤）。在所有情况下，所描述的标记都可以准确引导 MIS 接近肿瘤部位。在任何手术中都不需要术中透视或入路扩大。仅 4 名患者报告了术后并发症，与标记无关。计算机断层扫描图像引导的活性炭标记可以在肿瘤位于困难脊柱区域的情况下，以实用、可重复且有效的方式准确引导 MIS 入路。放射镜可视化。版权所有 © 神经外科医生大会 2024。保留所有权利。

To describe a novel, practical, reproducible, and effective preoperative marking technique for accurate localization of the spinal level in a series of patients with tumor lesions.We retrospectively analyzed patients undergoing minimally invasive (MIS) surgery for spine tumors from 2016 to 2021, in which this marking technique was used. Twenty-one patients, with tumor lesions involving difficult radioscopic visualization (cervicothoracic junction or upper dorsal spine, C6-T8), were included. Tumor lesion level was previously determined with enhanced MRI in all cases. Twenty-four to forty-eight hours before surgery, computed tomography image-guided carbon marking was performed by administration of aqueous suspension of carbon with a 21-gauge needle placed resembling the MIS approach planned trajectory. During surgery, activated carbon marking was followed until reaching the final target on the bone. Next, sequential dilators and an MIS retractor were placed. Then, bone resection and tumor exeresis were performed according to the case.Average age was 60.6 years (26-76 years). Fifteen (71%) patients were women. In most cases (76%), tumor pathology involved intradural lesions (meningiomas and schwannomas). In all cases, the marking described allowed to accurately guide the MIS approach to tumor site. Neither intraoperative fluoroscopy nor approach enlargement was required in any procedure. Postoperative complications were reported in only 4 patients, none related with the marking.Computed tomography image-guided activated carbon marking allows to accurately lead MIS approaches in a practical, reproducible, and effective way in cases of tumors localized in regions of the spine of difficult radioscopic visualization.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.