Nils Hecht1, Marije Kamphuis2, Marcus Czabanka1, Bernd Hamm3, Susanne König4, Johannes Woitzik1, Michael Synowitz1, Peter Vajkoczy5. 1. Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. 2. MIRA Institute for Biomedical and Technical Medicine, University of Twente, Enschede, The Netherlands. 3. Department of Diagnostic and Interventional Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany. 4. Department of Anesthesiology and Operative Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany. 5. Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany. peter.vajkoczy@charite.de.
Abstract
PURPOSE: Current solutions for navigated spine surgery remain hampered by restrictions in surgical workflow as well as a limited versatility and applicability. Against this background, we report the first experience of navigated spinal instrumentation with the mobile AIRO(®) intraoperative computed tomography (iCT) scanner. METHODS: AIRO(®) iCT was used for navigated posterior spinal instrumentation of 170 screws in 23 consecutive patients operated on in our Department between the first use of the system in May 2014 and August 2014. The indications for AIRO(®) were based on the surgical region, anatomical complexity and the need for >3 segment instrumentation. Following navigated screw insertion, screw positions were confirmed intraoperatively by a second iCT scan. CT data on screw placement accuracy were retrospectively reviewed and analyzed by an independent observer. RESULTS: AIRO(®)-based spinal navigation was easy to implement and successfully accomplished in all patients, adding around 18-34 min to the net surgery time. A systematic description of the authors' approach, setup in the OR and workflow integration of the AIRO(®) is presented. Analysis of screw placement accuracy revealed 9 (5.3%) screws with minor pedicle breaches (<2 mm). A total of 7 screws (4.1%) were misplaced >2 mm, resulting in an accuracy rate of 95.9%. CONCLUSIONS: The AIRO(®) system is an easy-to-use and versatile iCT for navigated spinal instrumentation and provides high pedicle screw accuracy rates. Although the authors' experience suggests that the learning curve associated with AIRO(®)-based spinal navigation is steep, a systematic user-based approach to the technology is required.
PURPOSE: Current solutions for navigated spine surgery remain hampered by restrictions in surgical workflow as well as a limited versatility and applicability. Against this background, we report the first experience of navigated spinal instrumentation with the mobile AIRO(®) intraoperative computed tomography (iCT) scanner. METHODS: AIRO(®) iCT was used for navigated posterior spinal instrumentation of 170 screws in 23 consecutive patients operated on in our Department between the first use of the system in May 2014 and August 2014. The indications for AIRO(®) were based on the surgical region, anatomical complexity and the need for >3 segment instrumentation. Following navigated screw insertion, screw positions were confirmed intraoperatively by a second iCT scan. CT data on screw placement accuracy were retrospectively reviewed and analyzed by an independent observer. RESULTS: AIRO(®)-based spinal navigation was easy to implement and successfully accomplished in all patients, adding around 18-34 min to the net surgery time. A systematic description of the authors' approach, setup in the OR and workflow integration of the AIRO(®) is presented. Analysis of screw placement accuracy revealed 9 (5.3%) screws with minor pedicle breaches (<2 mm). A total of 7 screws (4.1%) were misplaced >2 mm, resulting in an accuracy rate of 95.9%. CONCLUSIONS: The AIRO(®) system is an easy-to-use and versatile iCT for navigated spinal instrumentation and provides high pedicle screw accuracy rates. Although the authors' experience suggests that the learning curve associated with AIRO(®)-based spinal navigation is steep, a systematic user-based approach to the technology is required.
Authors: Ioannis D Gelalis; Nikolaos K Paschos; Emilios E Pakos; Angelos N Politis; Christina M Arnaoutoglou; Athanasios C Karageorgos; Avraam Ploumis; Theodoros A Xenakis Journal: Eur Spine J Date: 2011-09-07 Impact factor: 3.134
Authors: Jimmy Villard; Yu-Mi Ryang; Andreas K Demetriades; Andreas Reinke; Michael Behr; Alexander Preuss; Bernhard Meyer; Florian Ringel Journal: Spine (Phila Pa 1976) Date: 2014-06-01 Impact factor: 3.468
Authors: Dimitri Tkatschenko; Paul Kendlbacher; Marcus Czabanka; Georg Bohner; Peter Vajkoczy; Nils Hecht Journal: Eur Spine J Date: 2019-12-09 Impact factor: 3.134
Authors: Tarik Alp Sargut; Nils Hecht; Ran Xu; Georg Bohner; Marcus Czabanka; Julia Stein; Marcus Richter; Simon Bayerl; Johannes Woitzik; Peter Vajkoczy Journal: Eur Spine J Date: 2022-06-30 Impact factor: 2.721
Authors: Yann Philippe Charles; Rawan Al Ansari; Arnaud Collinet; Pierre De Marini; Jean Schwartz; Rami Nachabe; Dirk Schäfer; Bernhard Brendel; Afshin Gangi; Roberto Luigi Cazzato Journal: Sensors (Basel) Date: 2022-06-18 Impact factor: 3.847
Authors: Nils Beisemann; Jula Gierse; Eric Mandelka; Frank Hassel; Paul A Grützner; Jochen Franke; Sven Y Vetter Journal: Sci Rep Date: 2022-07-19 Impact factor: 4.996
Authors: Johannes Goldberg; Simon Heinrich Bayerl; Christian Witzel; Felix Aigner; Christopher P Ames; Peter Vajkoczy Journal: Neurosurg Rev Date: 2019-11-18 Impact factor: 3.042
Authors: R Vijayan; T De Silva; R Han; X Zhang; A Uneri; S Doerr; M Ketcha; A Perdomo-Pantoja; N Theodore; J H Siewerdsen Journal: Phys Med Biol Date: 2019-08-21 Impact factor: 4.174