New 3-D imaging makes spinal fusion surgeries more precise

Special to the Herald-LeaderSeptember 9, 2012 

Dr. Steven Kiefer, Central Baptist Health

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An unstable spine can be the source of significant pain and disability. Spinal fusion is a surgical procedure used to correct problems with the component bones of the spine called vertebrae.

The main idea is to fuse together the painful vertebrae so that they heal into a single, solid bone. With any type of spinal surgery, precision is key. There is a new tool called the Medtronic O-arm multidimensional Imaging System that allows surgeons to more precisely place hardware and to be able to check the placement to ensure that everything is in the most optimal position.

Traditionally, spinal surgery patients had imaging procedures such as CT scans, MRIs and X-rays done prior to surgery. During surgery, a C-arm X-ray machine offered views for the surgeon to check placement of screws and other hardware, but those views were limited to two dimensions, front to back and side to side. A true assessment of the placement of the hardware had to be done after surgery with additional CT scans, which provide cross-sectional 3-D images.

The O-arm makes spinal fusion surgery much more efficient and precise. At first glance, the O-arm resembles the traditional C-arm X-ray machine, but after proper positioning an additional part of the ring closes in around the patient to form the O, resembling a doughnut.

The O-arm provides three-dimensional X-ray imaging during surgery. Those images are imported to a computerized navigation system that projects them onto a monitor to guide the surgeon in placing instruments. The system can generate images during surgery that show exactly where the instruments extend inside the patient's body.

The spinal fusion surgical procedure itself hasn't changed, but the O-arm allows the surgeon to accomplish the procedure in a safer and more accurate fashion and often within a shorter time period. Patients rarely see this state-of-the-art equipment because they are already under anesthesia by the time it is in use. But patients reap the benefits of the O-arm because the system's multi-dimensional images allow surgeons to make the best decisions during surgery, which minimizes complications and the need for repeat surgeries.

Dr. Steven Kiefer is a neurosurgeon with Neurosurgical Associates at Central Baptist.

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