Radiation exposure using the O-arm® surgical imaging system

Pitteloud, Nicolas; Gamulin, Axel; Baréa, Christophe; Damet, J.; Racloz, Guillaume; Sans-Mercé, M.

doi:10.1007/s00586-016-4773-0

Cited by 49 publications

(40 citation statements)

References 8 publications

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“…O-arm devices can acquire up to 750 images in a single scan, and these images can be utilized with navigation systems to create 3D anatomical reconstructions[7,48,49]. The O-arm also is programmed with preset modes that optimize kilovoltage and miliampere settings for various patient sizes and anatomical regions[25,48,49]. Similar to the isocentric 3D C-arm, the O-arm can possibly reduce radiation exposure by allowing the surgical staff to exit the operating theatre during image acquisition[49].…”

Section: Intraoperative Three-dimensional Imaging and Spinal Navigatimentioning

confidence: 99%

“…The O-arm also is programmed with preset modes that optimize kilovoltage and miliampere settings for various patient sizes and anatomical regions[25,48,49]. Similar to the isocentric 3D C-arm, the O-arm can possibly reduce radiation exposure by allowing the surgical staff to exit the operating theatre during image acquisition[49]. …”

Section: Intraoperative Three-dimensional Imaging and Spinal Navigatimentioning

confidence: 99%

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Radiation exposure and reduction in the operating room: Perspectives and future directions in spine surgery

Narain

Hijji

Yom

et al. 2017

WJO

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Intraoperative imaging is vital for accurate placement of instrumentation in spine surgery. However, the use of biplanar fluoroscopy and other intraoperative imaging modalities is associated with the risk of significant radiation exposure in the patient, surgeon, and surgical staff. Radiation exposure in the form of ionizing radiation can lead to cellular damage via the induction of DNA lesions and the production of reactive oxygen species. These effects often result in cell death or genomic instability, leading to various radiation-associated pathologies including an increased risk of malignancy. In attempts to reduce radiation-associated health risks, radiation safety has become an important topic in the medical field. All practitioners, regardless of practice setting, can practice radiation safety techniques including shielding and distance to reduce radiation exposure. Additionally, optimization of fluoroscopic settings and techniques can be used as an effective method of radiation dose reduction. New imaging modalities and spinal navigation systems have also been developed in an effort to replace conventional fluoroscopy and reduce radiation doses. These modalities include Isocentric Three-Dimensional C-Arms, O-Arms, and intraoperative magnetic resonance imaging. While this influx of new technology has advanced radiation safety within the field of spine surgery, more work is still required to overcome specific limitations involving increased costs and inadequate training.

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Section: Intraoperative Three-dimensional Imaging and Spinal Navigatimentioning

confidence: 99%

Section: Intraoperative Three-dimensional Imaging and Spinal Navigatimentioning

confidence: 99%

Radiation exposure and reduction in the operating room: Perspectives and future directions in spine surgery

Narain

Hijji

Yom

et al. 2017

WJO

View full text Add to dashboard Cite

show abstract

“…The operating surgeon does not need to rely on the preoperative CT scan, which may be obscured with metal artifacts that make the bony landmarks difficult to identify. However, intraoperative CT scans are associated with increased radiation exposure, both to the surgical team and the patient [25]. Moreover, the cost of equipment and space occupied by the O-arm is relatively high when compared with CT-based navigation.…”

Section: Discussionmentioning

confidence: 99%

Does Three-Dimensional Printed Patient-Specific Templates Add Benefit in Revision Surgeries for Complex Pediatric Kyphoscoliosis Deformity with Sublaminar Wires in Situ? A Clinical Study

Shah¹,

Gadiya

Shah

et al. 2021

Asian Spine J

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To evaluate the accuracy of three-dimensional (3D) printed patient-specific templates (PSTs) for placement of pedicle screws (PAs) in patients undergoing revision surgeries for complex kyphoscoliosis deformity with sublaminar wires in situ. Overview of Literature: Revision kyphoscoliosis correction surgery in pediatric patients is a challenging task for the treating surgeon. In patients with sublaminar wires in situ, the native anatomical landmarks are obscured, thus making the freehand screw placement technique a highly specialized task. Hence, the concept of using PSTs for insertion of PAs in such surgeries is always intriguing and attractive. Methods: Five consecutive patients undergoing revision deformity correction with sublaminar wires in situ were included in this study. Patients were divided in two groups based on the technique of PA insertion. A total of 91 PAs were inserted using either a freehand technique (group A) or 3D printed templates (group B) (34 vs. 57). The placement of PAs was classified according to a postoperative computed tomography scan using Neo's classification. Perforation beyond class 2 (>2 mm) was termed as a misplaced screw. The average time required for the insertion of screws was also noted. Results: Mean age, surgical time, and blood loss were recorded. The change in mean Cobb's angle in both groups was also recorded. The difference in rates of misplaced screws was noted in group A and group B (36.21% vs. 2.56%); however, the mean number of misplaced PAs per patient in group A and group B was statistically insignificant (6.5±3.54 vs. 4.67±1.53, p=0.4641). The mean time required to insert a single PA was also statistically insignificant (120±28.28 vs. 90±30 seconds, p=0.3456). Conclusions: Although 3D printed PSTs help to avoid the misplacement of PAs in revision deformity correction surgeries with sublaminar wires in situ, the mean number of misplaced screws per patient using this technique was found to be statistically insignificant when compared with the freehand technique in this study.

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“…Though this technology may provide greater stereotactic information, current literature is mixed regarding improvements in hardware placement and raises additional concerns related to operative time and radiation exposure. [30][31][32] In a retrospective study, Laudato et al 30) noted that the use of the "O-arm" offered no significant improvements in pedicle screw placement when compared with freehand techniques. Conversely, when comparing the "O-arm" to the "C-arm," Verma et al noted that screw misplacement rates were 0.9% and 8.8%, respectively.…”

Section: Plain Radiographsmentioning

confidence: 99%

Imaging in Spine Surgery: Current Concepts and Future Directions

Harada

Siyaji

Younis

et al. 2020

Spine Surg Relat Res

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Study Design: Narrative Review Objective: To review and highlight the historical and recent advances of imaging in spine surgery and to discuss current applications and future directions Methods: A PubMed review of the current literature was performed on all relevant articles that examined historical and recent imaging techniques used in spine surgery. Studies were examined for their thoroughness in description of various modalities and applications in current and future management. Results: We reviewed 97 articles that discussed past, present, and future applications for imaging in spine surgery. Although most historical approaches relied heavily upon basic radiography, more recent advances have begun to expand upon advanced modalities, including the integration of more sophisticated equipment and artificial intelligence. Conclusion: Since the days of conventional radiography, various modalities have emerged and become integral components of the spinal surgeon's diagnostic armamentarium. As such, it behooves the practitioner to remain informed on the current trends and potential developments in spinal imaging, as rapid adoption and interpretation of new techniques may make significant differences in patient management and outcomes. Future directions will likely become increasingly sophisticated as the implementation of machine learning, and artificial intelligence has become more commonplace in clinical practice.

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Radiation exposure using the O-arm® surgical imaging system

Cited by 49 publications

References 8 publications

Radiation exposure and reduction in the operating room: Perspectives and future directions in spine surgery

Radiation exposure and reduction in the operating room: Perspectives and future directions in spine surgery

Does Three-Dimensional Printed Patient-Specific Templates Add Benefit in Revision Surgeries for Complex Pediatric Kyphoscoliosis Deformity with Sublaminar Wires in Situ? A Clinical Study

Imaging in Spine Surgery: Current Concepts and Future Directions

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