Understanding the Interactions with Image-Guidance System in Spine Navigated Surgery
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2017, Vol 1, Issue 1
Abstract
Image-guided technology has transformed spinal surgical interventions, in this review article the author attempts to understand the interactions with the most commonly used 3D system with the intraoperative cone beam CT, and develop a smooth workflow surgical plan. The system facilitates complex surgeries, minimizes radiation exposure to OR staff, and has advantages for minimally invasive surgeries. Aiming for safer surgeries, and understanding that navigation error is an interaction between technology and human factors. The technology used to acquire imaging for intra operative surgical navigation, has evolved from the discovery of X-rays in the late 19th century to the highly sophisticated intra operative Computed Tomography (CT) based navigation tools used today. Navigation has emerged as one of the most reliable representative of technology; as it continues to transform surgical interventions into safer and less invasive procedures [1]. The range of available technologies includes C-arm fluoroscopy, preoperative CT based navigation, 2D fluoroscopy based navigation, cone beam CT based navigation, and intraoperative CT based navigation. Aside from fluoroscopy, these imaging modalities implement the basic steps of image acquisition, registration to patient anatomy, processing, and navigation [2], the tracking systems are generally classified into magnetic, acoustic, laser; and infrared, the latter is the most commonly used and will be discussed in our review. Spinal instrumentation has made significant advances in the last two decades, with transpedicular constructs now widely used in spinal fixation. Pedicle screw constructs are routinely used in thoracolumbar-instrumented fusions, and in recent years, the cervical spine as well. Three-column fixations with pedicle screws provide the most rigid form of posterior stabilization [3]. Precision in pedicle screw placement is of utmost importance in any spinal fixation procedure, however, misplacement rates have been reported to range from 5% to 41% in lumbar spine, and from 3% to 55% in the thoracic spine when using conventional techniques [4], with as many as 7% of these misplaced screws resulting in neurological injuries [5]. The most commonly used forms of imageguided navigation in spine surgery presently include 2D images, in which a fluoroscope or plain radiography is used, and 3D navigation, making use of cone-beam CT or CT scans. The 3D systems provide projections of the operative field and instruments with imaging in 3 axes [6].
Authors and Affiliations
Khaldoun El Abed
Keywords
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- EP ID EP567586
- DOI 10.26717/BJSTR.2017.01.000153
- Views 157
- Downloads 0
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