Spine navigation software works in tandem with the surgeon to support their expertise and provide intraoperative insight and guidance.
Matthias Simon, MD, Head of Neurosurgery and Sami Ridwan, MD, Attending Neurosurgeon from @Evangelisches Klinikum Bethel - EvKB in Bielefeld, Germany take us through a spine navigation clinical workflow.
This case involves an 82 year old patient with back pain and claudication symptoms not responding to conservative treatment. MRI, X-Ray and CT images show mobile spondylolisthesis L4, 5 with relevant stenosis.
The workflow begins with positioning the patient in the line of sight of the navigation system’s infrared camera, after which the patient is draped. A calibration matrix is then used to calibrate the drill guide. With the help of a single X-Ray shot, the surgeon can locate the level at which the patient reference array will be attached.
The C-arm is then draped and a sterilizable tracking array is mounted facing the infrared camera. The C-arm then obtains an intraoperative 3D scan with the surgical team activating it with a foot pedal from outside the room.
The images are automatically transferred to the navigation system and instantly registered to the patient, the accuracy of which is measured with a pointer on the spinous process. Before making any incisions, the surgeon can plan the entry points and optimal trajectories for each screw with the surgical navigation system. Once planned, the drill is inserted through the guide to create a pilot hole. A K-wire is then inserted and the screw is placed.
To verify the correct placement of the screws, AP and lateral shots are taken and navigation used to determine access to the disc space. The disc is then removed, a cage is placed along with two rods. A final scan verifies the correct placement of the screws, rods and cage and the patient can be closed up.
To learn more about spinal navigation workflows with Brainlab technology, visit https://www.brainlab.com/surgery-products/overview-spinal-trauma-products/spinal-navigation/