MIS and percutaneous guiding systems

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How can the exposure of surgical teams to x-ray visualization systems be reduced? Can a MIS guiding device be helpful in navigating more quickly and more accurately? What procedures can benefit from such technology? ass.GIF

Minimal invasive surgery (MIS) means less post operative pain, minimal dissection of tissue and muscle, a much quicker recovery time and therefore a reduction in costs. MIS is the method of choice over traditional procedural, especially if it is combined with innovative ways of image processing technologies that require less exposure to x-ray radiation for surgeon and patient.

A start up company has developed such a minimal invasive method that supports a wide range of percutaneous spinal procedures both posterior and post-lateral. Using CT images as input the surgeon plans the operation to determine the bony anatomy and disc height, and the appropriate pedicle screw insertion points.

The system connects a workstation to a guiding frame and a fluoroscopy C-Arm, facilitating the planning procedure and enabling the surgeon to apply a sleeve, drill or other surgical instrument. Either a disposable clamp attaches to the patient’s spinous process or a T frame is mounted to the iliac crest and secured to one spinous process. Lateral and an AP set of fluoro images can be recorded and transferred to the workstation connected through the C-Arm and software then registers the image based data with integration of the fluoroscopic images to the pre-operative plan and data. The software allows the surgeon to plan the desired trajectory of the instruments on top of the reconstructed views. With a button on a touch screen at the workstation the operator can places the guidance arm of the miniature robotic system in the position and orientation planned by the surgeon.

The device combines robotics and image processing technologies for reliable guiding for trans-pedicular instrumentation, and has the potential to help in other surgical approaches, such as single- and multi-level fusions, as well as revision surgeries. Percutaneous guiding system have the potential to be effective in many procedures that currently rely on c-arm fluoro images.

Further – the future ain’t what it used to be.
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