The Role of Intraoperative Image Guidance Systems (Three-Dimensional C-arm versus O-arm) in Spinal Surgery: Results of a Single-Center Study

Banat, Mohammed; Wach, Johannes; Salemdawod, Abdallah; Bahna, Majd; Scorzin, Jasmin; Vatter, Hartmut

doi:10.1016/j.wneu.2020.11.013

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…Navigated surgery using the O-arm in combination with the Stealth Station has been successfully implemented in cranial and spinal interventions in people and recently for orthopedic interventions in equines ( 24 ). Cranial interventions are reported for endonasal surgeries of the skull base, hypophysectomy, and electrode placement for deep brain stimulation ( 32 , 33 ). The reported Euclidean vector error between 1.59 and 2.16 for electrode placement is similar to the median needle placement error obtained in the present study ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Feasability of a Frameless Brain Biopsy System for Companion Animals Using Cone-Beam CT-Based Automated Registration

et al. 2022

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The aim of the present study was to evaluate the use of a novel intraoperative cone-beam computed tomography (CBCT)-based automated registration system for frameless stereotactic brain biopsy in companion animals. An experimental cadaveric study evaluated thalamic and piriform lobe target site needle placement error in three dogs and three cats without a history of intracranial disease. Diagnostic accuracy and diagnostic yield were prospectively evaluated in twenty-four client-owned dogs and four cats with intracranial disease. Twenty-one procedures were performed post mortem (eighteen dogs and three cats), and seven biopsy procedures were performed in alive patients (six dogs and one cat). Procedural duration was evaluated in ten post mortem and four living patients. Outcome was evaluated in six dogs and one cat. In dogs, the calculated median needle placement error was 1.8 mm (range 0.71–2.84 mm) and 1.53 mm (range 1.45–1.99 mm) for piriform lobe and thalamus target sites, respectively. In cats, the calculated median needle placement error was 0.79 mm (range 0.6–1.91 mm) for the piriform lobe target site and 1.29 mm (range 0.47–2.69 mm) for the thalamic target site. The diagnostic yield was 96.4% (95% CI 0.81–0.99), the diagnostic accuracy was 94.4% (95% CI 0.72–0.99). Median total procedural duration for post mortem biopsies was 57.5 min (range 41–69 min). Median total procedural duration for intra vitam biopsies was 122.5 min (range 103–136 min). Three dogs were discharged 1 day after biopsy and one dog after 6 days. Two dogs and one cat were euthanized 24 and 48 h after biopsy. Intraoperative CBCT-based automated image registration for frameless stereotactic biopsies in companion animals is capable of providing diagnostic brain biopsy specimens independent of skull size and morphology with diagnostic yield and accuracy comparable to published values for diverse frameless and frame-based stereotaxy systems used in veterinary medicine. Duration of the procedure is not negatively affected and within the published range with other systems. Mobile intraoperative CBCT-based registration combined with neuronavigation delivers diagnostic brain biopsies in companion animals.

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Section: Discussionmentioning

confidence: 99%

Feasability of a Frameless Brain Biopsy System for Companion Animals Using Cone-Beam CT-Based Automated Registration

et al. 2022

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“…Current state-of-the-art CAS systems are, however, often installed with the newer O-arms, which potentially provide enhanced image quality. Although both systems offer high levels of accuracy, there is some evidence that the use of O-arms with CAS improves the level of accuracy [ 36 ]. Therefore, our results are not generalizable for all CAS set-ups.…”

Section: Discussionmentioning

confidence: 99%

The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial

Pijpker

Kuijlen

Tamási

et al. 2022

JPM

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In recent years, patient-specific spinal drill guides (3DPGs) have gained widespread popularity. Several studies have shown that the accuracy of screw insertion with these guides is superior to that obtained using the freehand insertion technique, but there are no studies that make a comparison with computer-assisted surgery (CAS). The aim of this study was to determine whether the accuracy of insertion of spinal screws using 3DPGs is non-inferior to insertion via CAS. A randomized controlled split-spine study was performed in which 3DPG and CAS were randomly assigned to the left or right sides of the spines of patients undergoing fixation surgery. The 3D measured accuracy of screw insertion was the primary study outcome parameter. Sixty screws inserted in 10 patients who completed the study protocol were used for the non-inferiority analysis. The non-inferiority of 3DPG was demonstrated for entry-point accuracy, as the upper margin of the 95% CI (−1.01 mm–0.49 mm) for the difference between the means did not cross the predetermined non-inferiority margin of 1 mm (p < 0.05). We also demonstrated non-inferiority of 3D angular accuracy (p < 0.05), with a 95% CI for the true difference of −2.30°–1.35°, not crossing the predetermined non-inferiority margin of 3° (p < 0.05). The results of this randomized controlled trial (RCT) showed that 3DPGs provide a non-inferior alternative to CAS in terms of screw insertion accuracy and have considerable potential as a navigational technique in spinal fixation.

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“…Meanwhile, as the C-arm is now a common tool to facilitate the FO procedure and 3D-CT showed better assistive performance, we believe that, with the assistance of 3D-CT, FO puncture is easier, and PBCs may show more potential in clinical practice. Recently, 3D C-arm, which could provide both 3D images and real-time guidance, was reported to be used in spinal operations and showed its potential [ 26 ]. However, 3D C-arm was not a common tool yet and rarely reported in TN operations.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Effectiveness and Safety between Intraoperative 3D-CT-Guided and C-Arm-Guided Percutaneous Balloon Compression for Idiopathic Trigeminal Neuralgia: A Multi-Center Retrospective Study

Xiao

Wei

Ren

et al. 2021

Pain Research and Management

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Objectives. To compare 3D-CT-guided and C-arm-guided percutaneous balloon compression (PBC) in terms of effectiveness and safety. Methods. The medical records and follow-up data of patients with idiopathic trigeminal neuralgia who underwent 3D-CT-guided or C-arm-guided PBCs in Beijing Tiantan Hospital and the Characteristic Medical Center of the Chinese People’s Armed Police Force between February 2018 and March 2020 were retrospectively reviewed and analysed. Results. A total of 291 patients were included. Among them, 212 patients underwent PBC treatment with 3D-CT and others with C-arm. One (0.5%) patient in 3D-CT group and 4 (5.1%) patients in C-arm group failed to receive PBC treatment because of failure of foramen ovale (FO) puncture ( P = 0.020 ). Among patients with successful attempts, 5 (2.4%) patients in the 3D-CT group and 11 (14.7%) patients in the C-arm group received more than one needle pass during the procedure ( P < 0.001 ). The 3D-CT group required less time than the C-arm group for puncture ( P < 0.001 ) and for the whole operation ( P < 0.001 ). The groups shared similar initial relief rates ( P = 0.749 ) and similar recurrence-free survival during follow-ups for a median of 22 months ( P = 0.839 ). No puncture-related complications occurred in either group and the two groups had similar incidences of compression-related complications. Conclusion. 3D-CT facilitated FO puncture and improved success rate of PBC. The overall time efficiency of PBC was also increased with 3D-CT. Thus, 3D-CT is a potentially useful image guidance technology for treating idiopathic trigeminal neuralgia by PBC.

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The Role of Intraoperative Image Guidance Systems (Three-Dimensional C-arm versus O-arm) in Spinal Surgery: Results of a Single-Center Study

Cited by 6 publications

References 21 publications

Feasability of a Frameless Brain Biopsy System for Companion Animals Using Cone-Beam CT-Based Automated Registration

Feasability of a Frameless Brain Biopsy System for Companion Animals Using Cone-Beam CT-Based Automated Registration

The Accuracy of Patient-Specific Spinal Drill Guides Is Non-Inferior to Computer-Assisted Surgery: The Results of a Split-Spine Randomized Controlled Trial

Comparison of Effectiveness and Safety between Intraoperative 3D-CT-Guided and C-Arm-Guided Percutaneous Balloon Compression for Idiopathic Trigeminal Neuralgia: A Multi-Center Retrospective Study

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