To assess the efficacy of using intraoperative cone-beam O-arm computed tomography and navigation system in surgical treatment of the spine and spinal cord disorders. A total of 106 patients with degenerative spine diseases and spine and spinal cord tumors underwent surgery with O-arm iCT and navigation system from August 2013 to March 2014. The iCT system was used for tumors localized in anatomically hard-to-reach areas to control radicality of removal of bone tumors and those of the spinal cord with ossification, and for needle guidance in vertebroplasty. During stabilization stage the O-arm iCT and navigation system were used to control the accuracy of implant placement and to monitor decompression zones. The O-arm iCT with navigation system is particularly useful when surgery is performed in difficult anatomical conditions, and the use of two-dimensional images does not provide visualization of the surgical zone. Duration of the first surgeries using iCT and navigation system was longer, but within the first month there was a trend towards its shortening. Conclusions. Application of the O-arm iCT with navigation system in surgical treatment of spinal disorders provides high quality treatment, is safe for a patient, and allows for surgical intervention in difficult anatomical conditions.
Robotic assistance recently gains increasing popularity in spinal surgery. Robotic assistance provides higher effectiveness and safety especially in complex anatomy environment. 16 patients with degenerative disc disease were operated with robotic assistance device («SpineAssist»; MAZOR Surgical Technologies, Caesarea, Israel). The robot was used for automated intraoperative positioning of the instruments according to preoperatively planned trajectories. Robotic assistance enabled optimal screw placement even in complex anatomical cases (thin pedicles and rotational deformity). No implant-related complications were recorded.
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