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Common OR Setup: The Only Imaging Device is a Mobile 2D X-Ray

Spine surgery is one of the most common Operating Room (OR) procedures.  The vast majority of surgeries are on a very short spinal segment, performed manually and guided only by standard 2D X-Ray imaging.


Increasingly, such interventions are aspiring to become less invasive and thus reliance on X-Ray guidance becomes even greater.  The enduring prevalence of X-Ray is explained by its simplicity, affordability and freedom in the selection of surgical tools.

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Need

Upgrading Common X-Ray Guidance to Address its Shortcomings

However, with X-Ray guidance the surgeon sees only top and side 2D views. The views needed most for tool insertion, namely vertebral cross-sections, are available only in a pre-operative 3D CT scan but not during surgery.

 

The lack of cross-sectional images during surgery can lead to errors that are detected only later, most notably the misplacement of implanted screws and the misdirection of injected cement.

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For Safe Insertions,

Cross-Sectional View is Best

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But Under X-Ray, Only Top & Side

2D Views are Available

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At the other end of the cost and complexity spectrum are today’s surgical navigation systems. They require on-tool and on-spine location sensors, a location tracking device, and typically a CT scanner added in the OR. Some are also robot-assisted. “Pain points” include an often-retrofitted operating room, costly hardware, cumbersome operation, restrictive workflow and forcing specific tools and implants. Despite being available for two decades, acceptance is limited mostly to complex inpatient surgeries at large medical centers. 

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