Minimal-invasive Computer-assistierte fluoroskopische Navigation der Kyphoplastie

Ohnsorge, J. A. K.; Siebert, C. H.; Schkommodau, Erik; Mahnken, Andreas H.; Prescher, Andreas; Weißkopf, M.

doi:10.1055/s-2005-836514

Cited by 13 publications

(6 citation statements)

References 13 publications

(25 reference statements)

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“…Balloon placement accuracy can be significantly improved and the radiation exposure during kyphoplasty can be reduced by as much as 76%, if computer-assisted fluoroscopic navigation is applied [44,45]. While relying on the navigator during the transpedicular balloon placement, balloon inflation and cement injection have to be performed under fluoroscopic control to minimise endplate fractures and cement leakage.…”

Section: Operation Technique Of Kyphoplastymentioning

confidence: 99%

Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations

et al. 2011

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Osteoporotic vertebral compression fractures are a menace to the elderly generation causing diminished quality of life due to pain and deformity. At first, conservative treatment still is the method of choice. In case of resulting deformity, sintering and persistent pain vertebral cement augmentation techniques today are widely used. Open correction of resulting deformity by different types of osteotomies addresses sagittal balance, but has comparably high morbidity. Besides conventional vertebral cement augmentation techniques balloon kyphoplasty has become a popular tool to address painful thoracic and lumbar compression fractures. It showed improved pain reduction and lower complication rates compared to standard vertebroplasty. Interestingly the results of two placebo-controlled vertebroplasty studies question the value of cement augmentation, if compared to a sham operation. Even though there exists now favourable data for kyphoplasty from one randomised controlled trial, the absence of a sham group leaves the placebo effect unaddressed. Technically kyphoplasty can be performed with a transpedicular or extrapedicular access. Polymethyl methacrylate (PMMA)-cement should be favoured, since calcium phosphate cement showed inferior biomechanical properties and less effect on pain reduction especially in less stable burst fractures. Common complications of kyphoplasty are cement leakage and adjacent segment fractures. Rare complications are toxic PMMA-monomer reactions, cement embolisation, and infection.

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Section: Operation Technique Of Kyphoplastymentioning

confidence: 99%

Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations

et al. 2011

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“…The correct positioning of these two C-arms is time-consuming, and the quality of the radiographs in osteoporotic and degenerative spine sometimes limited. 3D navigation is able to reduce fluoroscopic time significantly [18]. Especially if multiple levels have to be augmented, navigation is superior to conventional technique.…”

Section: Multilevel Kyphoplastymentioning

confidence: 99%

“…However, concerning the most popular application of image-guided approaches, pedicle screw insertion, the evidence of clinical benefit in the most critical areas, e.g., the thoracic spine, is still lacking. For many other areas of spine surgery, e.g., ventral spine or tumor surgery, image-guided approaches are still at an experimental stage [14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

O-arm®-based spinal navigation and intraoperative 3D-imaging: first experiences

Gonschorek

Hauck

Spiegl

et al. 2011

Eur J Trauma Emerg Surg

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Since the first use of instrument-tracking techniques in the early 1990s, image-guided technologies became a leading topic in all branches of spine surgery. Today, navigation is a widely available tool in spine surgery and has become a part of clinical routine in many centers for a large variety of indications. Spinal navigation may not only contribute to more precision during surgery, but it may also reduce radiation exposure and fluoroscopy time, with advantages not only for the patient but also for the operating room personnel. Different registration algorithms have been developed differing in terms of the type of image data used by the navigation system (preoperatively acquired computed tomography [CT] images, intraoperatively acquired fluoroscopy images) and the way virtual and physical reality is matched. There is a tendency toward a higher accuracy for 3D fluoroscopy-based registration algorithms. The O-arm(®) represents a new flat-panel technology with the source and detector moving in a 360° arc around the patient. In combination with the Stealth(®) station system, navigation may start immediately after automated registration with already referenced instruments. After instrumentation, an additional scan may confirm intraoperatively the correct positioning of the instrumentation. The first experiences with the system are described in this paper.

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“…

Einleitung

Nach der erstmalig beschriebenen Anwendung einer Pedikelschraube durch King 1948 revolutionierte die Etablierung des Pedikels als Implantatlager durch Roy-Camille [18] die Wirbelsäulenchirurgie. der navigierten Kyphoplastie [17].Ziel dieser prospektiven Studie war es, die auf präoperativer Computertomographie basierte navigierte Computer-gestützte Pedikelschraubenimplantation (Computer Assisted Orthopedic Surgery, CAOS) in puncto Präzision im Vergleich zur konventionellen Methode mittels Bildverstärker zu untersuchen, mit Daten aus der Literatur zu vergleichen und unsere Erfahrungen im Umgang mit dieser Technik zu berichten.

Derzeit existieren ca.…”

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“…Die Schraubenfehllagenraten in unserer Studie liegen mit 29,2% für die BV-gesteuerte Instrumentation und mit 8,3% für die Computer-navigierte Pedikelschraubenimplantation in dem in der Literatur angegebenen Bereich. der Kyphoplastie berichtet[17]. So wurden in den meisten Studien Patienten mit degenerativen Instabilitäten, Pseudarthrosen, Spinalkanalstenosen und postraumatisschen Kyphosen, jedoch keine Patienten mit skoliotischen Wirbelsäulendeformitäten behandelt[4,11].…”

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Prospektive Schraubenfehllagenanalyse nach konventioneller und navigierter Pedikelschraubenimplantation / Computer Assisted Orthopedic Surgery (CAOS)

Seller

Wild²,

Urselmann³

et al. 2005

Biomedizinische Technik/Biomedical Engineering

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Computer assisted surgery reduces significantly the misplacement rate of pedicle screws and remains for experienced spine surgeons an important support in the operative treatment of complex spinal deformities in future. Additionally it can be expected that Computer-Navigation will also spread out in the field of minimal-invasive spinal surgery, e.g. the kyphoplasty. The use of this technique supports beside the medical-technical knowledge an improved three-dimensional orientation in the education of spine surgeons.

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Minimal-invasive Computer-assistierte fluoroskopische Navigation der Kyphoplastie

Cited by 13 publications

References 13 publications

Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations

Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations

O-arm®-based spinal navigation and intraoperative 3D-imaging: first experiences

Prospektive Schraubenfehllagenanalyse nach konventioneller und navigierter Pedikelschraubenimplantation / Computer Assisted Orthopedic Surgery (CAOS)

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