tech navigational tool increases precision and accuracy of complex surgeries

O-arm=accuracy+precision O-arm=accuracy+precision

BY DENNY ANGELLE

Neurosurgeons at the Methodist Neurological Institute are the first in Texas to use the O-arm Imaging System, a multi-dimensional surgical navigation system for orthopedic and spine surgeries.

Five centuries ago, Christopher Columbus sailed across the Atlantic Ocean and discovered the New World. This, among his other explorations, would not have been possible without the invention of navigationaltools such as the sextant, compass and spyglass.

A modern-day navigational tool being used by neurosurgeons at The Methodist Hospital allows doctors to successfully perform complex surgeries with an unprecedented level of accuracy and precision. Like Columbus, these physicians are blazing a new trail because they are among the first in the country to use this technology.

The O-arm is a platform-mounted, portable scanner that allows doctors to peer into the patient at any time before or during surgery. It produces threedimensional pictures in a matter of seconds, saving valuable time while a patient is on the operating room table.

“This system gives us a much greater degree of accuracy in a much shorter time,” neurosurgeon Dr. Paul Holman explained. “In the past, mapping the surgical site was a time-consuming process.”

The O-arm transforms conventional two-dimensional fluoroscopic images into 3D guides for complex spinal surgeries. Surgeons also can call up a 3D reconstruction of the target area, with images of the spine and surrounding tissue.

The higher resolution of the images then allows physicians to more accurately place screws and other instruments to repair the spine.

Screws often are used in spinal corrective surgery to anchor a rod that then serves to straightenthe spine. They are used in repairing a spinal fracture, removal of tumors and lumbar decompression to relieve pain caused by pinched nerves.

Surgeons traditionally use anatomic landmarks (obtained by conventional X-ray technology) to place screws in the spine. But the natural difference in patients’ anatomy — bone density, shape, thickness — makes the margin for error very small.

Holman says the O-arm technology automatically matches the patient’s anatomy to reduce any misplacement of hardware.

“When you’re placing screws they have to be accurate,” Holman said. “A misaligned screw can cause some problems that would have to be fixed with a second, follow-up surgery. So you can see how a more accurate map gives us an advantage in the operating room.”

The O-arm’s unique shape allows for 360-degree views of a patient. The doughnut shaped platform moves while the patient is still — which means better operating room efficiency and greater patient safety. When it is not in use, the device can be folded away to keep it from getting in the surgeons’ way. H olman has used the O-arm in nearly 30 operations over the past few months. He finds the technology is most useful on thoracic spinal surgeries, closer to the neck and head.

“On the lower end of the spine, you have fewer nerves to worry about. The higher you get, the more accurate you need to be in placing any type of screws or implants,” he said.

Other neurosurgeons at Methodist, including Dr. J. Bob Blacklock and Dr. Rob Parrish, are proficient in the O-arm technology. “This technology is a real advance in our ability to perform complex spinal procedures and provide the most advanced care available,” Blacklock said.

In time, this imaging system can be used in more routine procedures, including minimally invasive surgeries that have smaller incisions and shorter patient recovery time.

“Computer assisted surgical navigation is a growing trend for minimally invasive spine procedures,” Holman said. “I think in a few years you are going to find this technology in hospitals all around the country.”

Above: The doughnut shaped O-arm provides surgeons with a 360-degree view of the patient. The 30-inch flat panel monitor provides superior image quality and a very large field of view.