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European Journal of Trauma and Emergency Surgery

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01.04.2011 | Original Article

O-arm^®-based spinal navigation and intraoperative 3D-imaging: first experiences

verfasst von: O. Gonschorek, S. Hauck, U. Spiegl, T. Weiß, R. Pätzold, V. Bühren

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2011

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Abstract

Since the first use of instrument-tracking techniques in the early 1990s, image-guided technologies became a leading topic in all branches of spine surgery. Today, navigation is a widely available tool in spine surgery and has become a part of clinical routine in many centers for a large variety of indications. Spinal navigation may not only contribute to more precision during surgery, but it may also reduce radiation exposure and fluoroscopy time, with advantages not only for the patient but also for the operating room personnel. Different registration algorithms have been developed differing in terms of the type of image data used by the navigation system (preoperatively acquired computed tomography [CT] images, intraoperatively acquired fluoroscopy images) and the way virtual and physical reality is matched. There is a tendency toward a higher accuracy for 3D fluoroscopy-based registration algorithms. The O-arm^® represents a new flat-panel technology with the source and detector moving in a 360° arc around the patient. In combination with the Stealth^® station system, navigation may start immediately after automated registration with already referenced instruments. After instrumentation, an additional scan may confirm intraoperatively the correct positioning of the instrumentation. The first experiences with the system are described in this paper.

Gertzbein SD, Robbins SE. Accuracy of pedicular screw placement in vivo. Spine. 1990;15:11–4.PubMedCrossRef

Nolte LP, Visarius H, Arm E, Langlotz F, Schwarzenbach O, Zamorano L. Computer-aided fixation of spinal implants. J Image Guid Surg. 1995;1:88–93.PubMedCrossRef

Nolte LP, Zamorano L, Visarius H, Berlemann U, Langlotz F, Arm E, Schwarzenbach O. Clinical evaluation of a system for precision enhancement in spine surgery. Clin Biomech. 1995;10:293–303.CrossRef

Weinstein JN, Spratt KF, Spengler D, Brick C, Reid S. Spinal pedicle fixation: reliability and validity of roentgenogram-based assessment and surgical factors on successful screw placement. Spine. 1988;13:1012–8.PubMedCrossRef

Arand M, Hartwig E, Hebold D, Kinzl L, Gebhard F. Precision analysis of navigation-assisted implanted thoracic and lumbar pedicled screws. A prospective clinical study. Unfallchirurg. 2001;104:1076–81.PubMedCrossRef

Holly LT, Foley KT. Intraoperative spinal navigation. Spine. 2003;28:S54–61.PubMedCrossRef

Holly LT, Foley KT. Percutaneous placement of posterior cervical screws using three-dimensional fluoroscopy. Spine. 2006;31:536–40.PubMedCrossRef

Laine T, Lund T, Ylikoski M, Lohikoski J, Schlenzka D. Accuracy of pedicle screw insertion with and without computer assistance: a randomised controlled clinical study in 100 consecutive patients. Eur Spine J. 2000;9:235–40.PubMedCrossRef

Rajasekaran S, Vidyadhara S, Ramesh P, Shetty AP. Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries. Spine. 2007;32:E56–64.PubMedCrossRef

10.

Reinhold M, Bach C, Audigé L, Bale R, Attal R, Blauth M, Magerl F. Comparison of two novel fluoroscopy-based stereotactic methods for cervical pedicle screw placement and review of the literature. Eur Spine J. 2008;17:564–75.PubMedCrossRef

11.

Schnake KJ, König B, Berth U, Schroeder RJ, Kandziora F, Stöckle U, Raschke M, Haas NP. Accuracy of CT-based navitation of pedicle screws in the thoracic spine compared with conventional technique. Unfallchirurg. 2004;107:104–12.PubMedCrossRef

12.

Stöckle U, Schäffler A, König B, Haas NP. Integrated navigation. Preclinical evaluation and initial clinical experience. Unfallchirurg. 2006;109:925–31.PubMedCrossRef

13.

Verma R, Krishan S, Haendlmayer K, Mohsen A. Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review and meta-analysis of 23 studies including 5,992 pedicle screws. Eur Spine J. 2010;19:370–5.PubMedCrossRef

14.

Arand M, Hartwig E, Kinzl L, Gebhard F. Spinal navigation in tumor surgery of the thoracic spine: first clinical results. Clin Orthop Relat Res. 2002;399:211–8.PubMedCrossRef

15.

Gebhard F, Kinzl L, Hartwig E, Arand M. Navigation of tumors and metastases in the area of the thoraco-lumbar spine. Unfallchirurg. 2003;106:949–55.PubMed

16.

Gonschorek O, Katscher S, Verheyden AP, Stockmar C, Josten C. Standardized CT/fluoro matched navigation for the anterior stabilization of thoracolumbar spine fractures. In: Lemke HU, Inamura K, Doi K, Vannier MW, Farmann AG, editors. Computer assisted radiology and surgery. Philadelphia: Elsevier; 2005. p. 670–3.

17.

Maier B, Zheng G, Ploss C, Zhang X, Welle K, Nolte LP, Marzi I. A CT-free, intra-operative planning and navigation system for minimally invasive anterior spinal surgery—an accuracy study. Comput Aided Surg. 2007;12:233–41.PubMed

18.

Ohnsorge JA, Siebert CH, Schkommodau E, Mahnken AH, Prescher A, Weisskopf M. Minimally-invasive computer-assisted fluoroscopic navigation for kyphoplasty. Z Orthop Ihre Grenzgeb. 2005;143:195–203.PubMedCrossRef

19.

Izadpanah K, Konrad G, Südkamp NP, Oberst M. Computer navigation in balloon kyphoplasty reduces the intraoperative radiation exposure. Spine. 2009;34(12):1325–9.PubMedCrossRef

20.

Rampersaud YR, Foley KT, Shen AC, Williams S, Solomito M. Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion. Spine. 2000;25:2637–45.PubMedCrossRef

21.

Gebhard FT, Kraus MD, Schneider E, Liener UC, Kinzl L, Arand M. Does computer-assisted spine surgery reduce intraoperative radiation doses? Spine. 2006;31:2024–7.PubMedCrossRef

22.

Linhardt O, Perlick L, Lüring C, Stern U, Plitz W, Grifka J. Extracorporeal single dose and radiographic dosage in image-controlled and fluoroscopic navigated pedicle screw implantation. Z Orthop Ihre Grenzgeb. 2005;143:175–9.PubMedCrossRef

23.

Holly LT, Bloch O, Johnson JP. Evaluation of registration techniques for spinal image guidance. J Neurosurg Spine. 2006;4:323–8.PubMedCrossRef

24.

Lekovic GP, Potts EA, Karahalios DG, Hall G. A comparison of two techniques in image-guided thoracic pedicle screw placement: a retrospective study of 37 patients and 277 pedicle screws. J Neurosurg Spine. 2007;7:393–8.PubMedCrossRef

25.

Mirza SK, Wiggins GC, Kuntz C 4th, York JE, Bellabarba C, Knonodi MA, Chapman JR, Shaffrey CI. Accuracy of thoracic vertebral body screw placement using standard fluoroscopy, fluoroscopic image guidance, and computed tomographic image guidance: a cadaver study. Spine. 2003;28:402–13.PubMedCrossRef

26.

Nottmeier EW, Crosby TL. Timing of paired points and surface matching registration in three-dimensional (3D) image-guided spinal surgery. J Spinal Disord Tech. 2007;20:268–70.PubMedCrossRef

27.

Geerling J, Gösling T, Gösling A, Ortega G, Kendoff D, Citak M, Krettek C, Hüfner T. Navigated pedicle screw placement: experimental comparison between CT- and 3D fluoroscopy-based techniques. Comput Aided Surg. 2008;13:157–66.PubMed

28.

Hott JS, Papadopoulos SM, Theodore N, Dickman CA, Sonntag VK. Intraoperative Iso-C C-arm navigation in cervical spinal surgery: review of the first 52 cases. Spine. 2004;29:2856–60.PubMedCrossRef

29.

Siewerdsen JH, Moseley DJ, Burch S, Bisland SK, Bogaards A, Wilson BC, Jaffray DA. Volume CT with a flat-panel detector on a mobile, isocentric C-arm: pre-clinical investigation in guidance of minimally invasive surgery. Med Phys. 2005;32:241–54.PubMedCrossRef

30.

Wendl K, von Recum J, Wentzensen A, Grützner PA. Iso-C(3D0-assisted) navigated implantation of pedicle screws in thoracic lumbar vertebrae. Unfallchirurg. 2003;106:907–13.PubMed

31.

Holly LT, Foley KT. Image guidance in spine surgery. Orthop Clin North Am. 2007;38:451–61.PubMedCrossRef

32.

Richter M, Amiot LP, Puhl W. Computer navigation in dorsal instrumentation of the cervical spine—an in vitro study. Orthopade. 2002;31:372–7.PubMedCrossRef

33.

Acosta FL Jr, Quinones-Hinojosa A, Gadkary CA, Schmidt MH, Chin CT, Ames CP, Rosenberg WS, Weinstein P. Frameless stereotactic image-guided C1–C2 transarticular screw fixation for atlantoaxial instability: review of 20 patients. J Spinal Disord Tech. 2005;18:385–91.PubMedCrossRef

34.

Börm W, König RW, Albrecht A, Richter HP, Kast E. Percutaneous transarticular atlantoaxial screw fixation using a cannulated screw system and image guidance. Minim Invasive Neurosurg. 2004;47:111–4.PubMedCrossRef

35.

Chibbaro S, Benvenuti L, Carnesecchi S, Marsella M, Serino D, Gagliardi R. The use of virtual fluoroscopy in managing acute type II odontoid fracture with anterior single-screw fixation. A safe, effective, elegant and fast form of treatment. Acta Neurochir. 2005;147:735–9.CrossRef

36.

Arand M, Hartwig E, Kinzl L, Gebhard F. Spinal navigation in cervical fractures—a preliminary clinical study on Judet-osteosynthesis of the axis. Comput Aided Surg. 2001;6:170–5.PubMed

37.

Battaglia TC, Tannoury T, Crowl AC, Chan DP, Anderson DG. A cadaveric study comparing standard fluoroscopy with fluoroscopy-based computer navigation for screw fixation of the odontoid. J Surg Orthop Adv. 2005;14:175–80.PubMed

38.

Bloch O, Holly LT, Park J, Obasi C, Kim K, Johnson JP. Effect of frameless stereotaxy on the accuracy of C1–2 transarticular screw placement. J Neurosurg. 2001;95:74–9.PubMed

39.

Ebmeier K, Giest K, Kalff R. Intraoperative computerized tomography for improved accuracy of spinal navigation in pedicle screw placement of the thoracic spine. Acta Neurochir Suppl. 2003;85:105–13.PubMed

40.

Hart RA, Hansen BL, Shea M, Hsu F, Anderson GJ. Pedicle screw placement in the thoracic spine: a comparison of image-guided and manual techniques in cadavers. Spine. 2005;30:E326–31.PubMedCrossRef

41.

Kosmopoulos V, Schizas C. Pedicle screw placement accuracy: a meta-analysis. Spine. 2007;32:E111–20.PubMedCrossRef

42.

Rampersaud YR, Pik JH, Salonen D, Farooq S. Clinical accuracy of fluoroscopic computer-assisted pedicle screw fixation: a CT analysis. Spine. 2005;30:E183–90.PubMedCrossRef

43.

Ruf M, Wagner R, Merk H, Harms J. Preoperative planning and computer assisted surgery in ankylosing spondylitis. Z Orthop Ihre Grenzgeb. 2006;144:52–7.PubMedCrossRef

44.

Acosta FL Jr, Thompson TL, Campbell S, Weinstein PR, Ames CP. Use of intraoperative isocentric C-arm 3D fluoroscopy for sextant percutaneous pedicle screw placement: case report and review of the literature. Spine J. 2005;5:339–43.PubMedCrossRef

45.

Fritsch E, Duchow J, Seil R, Grunwald I, Reith W. Accuracy of fluoroscopic navigation of pedicle screws. CT-based evaluation of bone screw placement. Orthopade. 2002;31:385–91.PubMedCrossRef

46.

Gebhard F, Kraus M, Schneider E, Arand M, Kinzl L, Hebecker A, Bätz L. Radiation dosage in orthopedics—a comparison of computer-assisted procedures. Unfallchirurg. 2003;106:492–7.PubMedCrossRef

47.

Assaker R, Cinquin P, Cotten A, Lejeune JP. Image-guided endoscopic spine surgery: Part I. A feasibility study. Spine. 2001;26:1705–10.PubMedCrossRef

48.

Assaker R, Reyns N, Pertruzon B, Lejeune JP. Image-guided endoscopic spine surgery: Part II: clinical applications. Spine. 2001;26:1711–8.PubMedCrossRef

49.

Johnson JP, Stokes JK, Oskouian RJ, Choi WW, King WA. Image-guided thoracoscopic spinal surgery: a merging of 2 technologies. Spine. 2005;30:E572–8.PubMedCrossRef

50.

Kim CW, Lee YP, Taylor W, Oygar A, Kim WK. Use of navigation-assisted fluoroscopy to decrease radiation exposure during minimally invasive spine surgery. Spine J. 2008;8:584–90.PubMedCrossRef

51.

Thoranaghatte RU, Zheng G, Langlotz F, Nolte LP. Endoscope-based hybrid navigation system for minimally invasive ventral spine surgeries. Comput Aided Surg. 2005;10:351–6.PubMed

Titel: O-arm®-based spinal navigation and intraoperative 3D-imaging: first experiences
verfasst von: O. Gonschorek
S. Hauck
U. Spiegl
T. Weiß
R. Pätzold
V. Bühren
Publikationsdatum: 01.04.2011
Verlag: Springer-Verlag
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 2/2011
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-011-0089-2

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