[Experience of using an intraoperative cone beam computed tomography scanner and the modern navigation system in surgical treatment of spine and spinal cord disorders].

Abstract

UNLABELLED: Spine disorders are a highly relevant problem in neurosurgical pathology. The development of diagnostic imaging methods makes it possible to perform intraoperative computed tomography. A special intraoperative cone beam computed tomography scanner "O-arm" has been designed; it combines a function of a C-arm machine and computer tomography scanner. The O-arm system can be used along with navigation system and robotic assistance device. Availability of these devices in an operating room allowed us to study the effectiveness and features of intraoperative CT imaging. OBJECTIVE: To evaluate the intraoperative use a cone beam computed tomography scanner "O-arm" and the navigation system in surgical treatment of spine disorders. MATERIAL AND METHODS: In August-November 2013, 43 patients with degenerative spine disorders, spine and spinal canal tumors underwent surgeries at the N.N. Burdenko Neurosurgical Institute using an intraoperative computed tomography scanner "O-arm" and the navigation system. RESULTS: It is reasonable to use intraoperative CT "O-arm" device with the navigation system when surgical treatment is performed under complex anatomical conditions (a thin root of the vertebral arch, scoliotic or post-traumatic spinal deformity) and the surgery zone cannot be visualized using 2D imaging methods. Intraoperative CT control and navigation system can be employed by neurosurgeons in clinics where the standard stabilizing surgeries and percutaneous methods either are employed rarely or have just started to be used. CONCLUSIONS: The use of an intraoperative CT device "O-arm" with the modern navigation system for surgical treatment of spine and spinal cord disorders allows one to perform surgical interventions under complex anatomical conditions, reduces the absorbed radiation dose, and is safe for patients.