Technologically Enhanced

3D C-arm and Navigation in Spine Surgery

Spine surgery has experienced much technological innovation over the past decades. The field has seen advancements in operative techniques, implants, biologics and equipment such as computer-assisted navigation and surgical robotics. With the arrival of real-time image guidance and imaging ability to process and reconstruct these data into an interactive three-dimensional spinal “map”, a surgeon is better equipped than ever for understanding and tackling the complications in a surgical field.

Precision takes paramount importance especially when a surgery is associated with important neurovascular elements. Spine surgery commonly involves placing permanent implants inside a patient’s body. These implants have to be placed accurately taking great care not to injure the surrounding nerves and vessels. Till now, a conventional C-arm was used for such procedures which provided images in AP and lateral planes. The quality of the images depended a lot on the level of surgery and the soft tissue depth. For these reasons, it often provided poor images in obese patients and in surgeries at thoracic level. But the introduction of 3D C-arm has virtually removed the guesswork out of spine surgery.

A precise 3-dimensional anatomic information provided by image-guided technology provides multiplanar visualisation which allows for any surgical instrument to be tracked in real time with reference to the anatomy. The applications for intraoperative navigation and 3-dimensional imaging are especially beneficial in complex cases such as resection of spinal column and intradural tumours, revision procedures for arthrodesed spines, and deformity cases with distorted anatomy. Implants such as pedicle screws can be placed in a deformed spine to an accuracy of 1/10th of a millimetre. Additionally, these platforms may mitigate much of the harmful radiation exposure in minimally invasive surgery to which the patient, surgeon, and ancillary operating room staff are subjected. In routine procedures like bone biopsy, it has proved to be a safer option compared to CT scan guided biopsy by significantly reducing the radiation exposure to the patient.

With 3D C-arm and navigation, the future of spine surgery is here.



Dr. Mihir Bapat

Dr. Mihir Bapat

Director
Institute of Spine Surgery
Minimal Invasive
Spine Surgery
Nanavati Super Speciality
Hospital, Mumbai

Dr. Malini Thomas

Dr. Amandeep Gujral

Consultant
Minimal Invasive
Spine Surgery
Nanavati Super Speciality
Hospital, Mumbai