Radiation Free Navigation for Spine Surgery: A Cadaveric Study
2Spine Surgery, The Rothman Orthopedic Institute, USA
3Spine, Pathkeeper, Israel
4Spine Surgery, Washington Orthopedic and Sport Medicine, USA
Introduction:
Surgery and spine surgery specifically are using increasing amounts of ionizing radiation in order to allow tracking and navigation during surgery. This increase in harmful radiation increases the risk of cancer for both the patients and the surgical staff. In addition, in cases in which the spine is mobile, the vertebras move during the case causing decreased accuracy reaching several millimeter accuracy as the case progress.
In light of these issues, research into optical imaging and navigation has been conducted to allow a radiation-free solution.
Materials and Methods:
Using a specialized high definition 3D camera, augmented technology for optical imaging and AI software allowing radiation free matching of the preoperative imaging to the real anatomy of a patient, pedicle screws were planned and executed in thoracolumbar in 7 cadavers (both female and male). Real time tracing and imaging was tested in all cases. Screw accuracy was tested by postoperative computed tomography (CT) imaging.
Results:
80 pedicle screws were inserted by five surgeons using optical navigation between T2 and L5 vertebrae, using the real-time tracking software. In order to assess real time tracking, during the procedure the cadavers were moved, in addition extensive dissection and osteotomies of spine were performed in order to allow spine motion during procedures. Real time tracking and imaging was tested and successful throughout the cases, proving a submillimeter accuracy throughout the case.
Accuracy rate using system guidance was 100% throughout surgery as well as in postoperative CT verification in all cadavers.
Summary:
Optical navigation is an emerging new technology that provides a safe solution for a radiation free spine surgery. As this technology continues to evolve allowing sub-millimeter accuracy and real time imaging, it shall be able to decrease the need of intraoperative CT scans for patients. Live patient testing is needed to translate this promising technology from the bench to the operating room table.