The cervical spine involves the vertebral bodies inferior to the skull. The most important issue is the proximity to the central nervous system and the vertebral arteries.
In case of injury, e.g. fractures or dislocation, the damage can be massive, such as respiratory failure or complete paralysis. Surgery in this area is extremely challenging for the spine surgeon. It demands the highest precision within very little space. This is a situation in which the combination of the fast and accurate intraoperative 2D and 3D imaging imaging and the navigation system provides the surgeon precise guidance and visualization of the anatomy.
The placement of the screws is verified right in the OR. Implants that may not be ideally positioned can be corrected immediately. Patients can count on optimal postoperative results. The intraoperative quality control leads to better outcomes and fewer secondary surgeries.
Explore how cervical spine surgery can profit from high-end imaging in the Medical Knowledge Corner.
The lumbar spine is the lower end of the spine, consisting of the 5 vertebral bodies between the pelvis and the thorax. This part of the spine helps to support the weight of the body and permits movements of the lower extremities.
It is mostly affected by degenerative diseases. Demographic or life style issues like being overweight and sedentary lifestyle add to this disease. Most of the worldwide population suffers from lower back pain at least once.
The trend toward minimally invasive surgery is very strong in lumbar spine surgery. Small incisions compared to open surgery allow the patient to recover more quickly. High quality imaging enables the surgeon to place the screws with confidence.
The Artis zeego system provides a large field of up to seven vertebras with a 30 cm x 40 detector size. With the possibility of a rotation of the detector from landscape to portrait, a larger segment of the spine can be visualized in one image shot. The power generator enables high quality images to be acquired even in obese patients where the anatomy is challenging, like at the thoracolumbar junction. An image of up to 24 cm x 45 cm can be acquired. This field of view has never been possible before.
Learn more about lumbar spine surgery with Artis zeego systems in the Medical Knowledge Corner.
Scoliosis is a curved 3-dimensional deformity of the entire spine, often affecting the cervical, thoracic, and lumbar spine. The origin is either congenital, idiopathic or results as a secondary condition from a neuromuscular disease.
The disease affects young patients as well as older patients who experience later onset of the disease. In young patients, scoliosis can cause severe deformity if untreated, and lead to pulmonary malfunction. There are various non-surgical treatment options. However, surgery is recommended in very specific cases or if conservative methods are insufficient.
For these long stretches of the spine, the placement of screws is even a bigger challenge. The large field of view and high image quality of the Artis zeego support this process. The fixation of the spinal implants is controlled with fluoroscopy. Even with the large frames and all the surgical instruments, fluoroscopy can be easily performed with the C-arm of the robotic system.
If surgery requires a lateral approach through the thorax, a double luminar tube is necessary. In this case the patient is positioned on the left side and surgery is performed through the right thorax. The thorax is opened through small incisions and an endoscope is used to guide the surgical instruments. Intraoperative imaging plays a decisive role.
Using the minimally invasive approach, the surgeon loses tactile sense and natural 3D vision. He or she has to fully rely on the images provided by the endoscope and the Artis zeego.
For the dorsal approach the patient is positioned in prone position. The syngo spine composing software of the robotic C-arm system allows stitching multiple images of segments of the spine into one image. The surgeon is able to evaluate the severity of the deformity, plan thoroughly and assess the success of the procedure.
The Automap function allows positions and angulations of the Artis zeego to be easily stored and reached whenever needed with only a few clicks. This speeds up the procedure and facilitates surgical workflow.
At the end of the procedure, the surgeon verifies the position of the screws. With the help of the syngo DynaCT Large Volume and the image composing option, the surgeon can visualize the entire spine in a few steps. Any screw that requires repositioning can be adjusted right in the OR.
Learn more about treatment of spinal deformities in hybrid ORs in the Medical Knowledge Corner.
Medical Knowledge Corner
Explore our collection of case studies, clinical workflows, videos, brochures and scientific publications for Spine surgery.
Navigated dorsal stabilization of the spine (short)
Navigated dorsal stabilization of the spine (long)
Robotic 3D imaging for spinal fusion (short)
Robotic 3D imaging for spinal fusion (long)
Sahlgrenska - a multidisciplinary story with Artis zeego (Short version)
Sahlgrenska - a multidisciplinary story with Artis zeego (Long Version)
Spine-Type A and osteoporotic fractures
Clinical webcast from the University of Ulm, Germany, about Spine-Type A and osteoporotic fractures by Professor Dr. Florian Gebhard and Prof. Dr. Thomas Blattert.
Click here to view the webcast (Copyright by AO Foundation, Switzerland)