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Navigation surgery


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Navigation surgery

  1. 1. G.S. Sapkas 1st Orthopaedic Department University Hospital “ATTIKON” Medical School Athens University
  2. 2. Introduction to Image-Guided Surgery  Since the mid-1970’s, image-guided surgery has emerged as an accepted and clinically appropriate alternative to traditional surgery.
  3. 3. SSuurrggiiccaall nnaavviiggaattiioonn hhaass::  Revolutionized operating room procedures  Enhanced pre-operative planning  Improved intra-operative effectiveness and efficiency  Increased the speed of post-operative recovery, and  Improved clinical outcomes
  4. 4.  Modern image-guided surgery has been described in the clinical literature using a variety of terms such as:  “surgical navigation,”  “computer assisted surgery,”  “surgical stimulation,”  “3-D computer surgery,”  “surgical navigation”
  5. 5. Using surgical navigation methods, physicians may make more accurate diagnoses before and during surgery.
  6. 6.  Advanced technologies pr ovide  computerized, three-dimensional viewing  so physicians and surgical teams can precisely locate and position surgical instruments in the anatomic field and view the results on their visual displays
  7. 7. As a result, procedures are shorter and protocols are improved.
  8. 8.  Surgical navigation may also be less invasive than traditional surgery as surgeons may be more accurate using technologically advanced devices in place of (or in addition to) the traditional hand-guided, mechanical devices during surgery.
  9. 9.  This allows for an increased level of patient safety and an overall reduction in patient morbidity.
  10. 10.  In addition, recent enhancements to surgical navigation technology have enabled new and more minimally invasive procedures to be possible.
  11. 11. Current usage of Spinal Navigation and Intra-operative Imaging
  12. 12. Key spine procedures, challenges with traditional surgery  Posterior Cervical Fusion  C1-C2 fusion  Pedicle screws  Posterior Thoracic Fusion (upper thoracic spine)  Thoracolumbar spine
  13. 13.  Spinal trauma  Minimally invasive trauma (screws and rods percutaneously)
  14. 14. Pediatric and adult deformity
  15. 15. Posterior Lumbar Fusion  Degeneration of the lumbar spine  Minimally invasive lumbar fusion  Revision surgeries
  16. 16. IImmaaggee gguuiiddeedd ssppiinnee ssuurrggeerryy:: ssttaattee ooff tthhee aarrtt aanndd ffuuttuurree ddiirreeccttiioonnss Thorsten T. et al, Eur. Spine 2010 Review article
  17. 17.  BBaasseedd oonn aa mmeeddlliinnee sseeaarrcchh ttoottaall ooff 11..446622 ppuubblliiccaattiioonnss ppuubblliisshheedd uunnttiill OOccttoobbeerr 22000088 wweerree rreettrriieevveedd  227766 ppaappeerrss wweerree iinncclluuddeedd iinn tthhee aannaallyyssiiss  OOnnllyy ttwwoo RRCCTTss aanndd oonnee mmeettaa--aannaallyyssiiss hhaavvee bbeeeenn rreettrriieevveedd
  18. 18.  CCoonncceerrnniinngg tthhee mmoosstt ppooppuullaarr aapppplliiccaattiioonn ooff iimmaaggee gguuiiddeedd aapppprrooaacchheess ppeeddiiccllee ssccrreeww iinnsseerrttiioonn,, tthhee eevviiddeennccee ooff cclliinniiccaall bbeenneeffiitt iinn tthhee mmoosstt ccrriittiiccaall aarreeaass tthhee tthhoorraacciicc ssppiinnee iiss ssttiillll llaacckkiinngg
  19. 19.  IInn mmaannyy ootthheerr aarreeaass ooff ssppiinnee ssuurrggeerryy vveennttrraall ssppiinnee ssuurrggeerryy oorr ttuummoorr ssuurrggeerryy,, iimmaaggee gguuiiddeedd aapppprrooaacchheess aarree ssttiillll iinn eexxppeerriimmeennttaall ssttaaggeess
  20. 20.  TThhee tteecchhnniiccaall ddeevveellooppmmeenntt ooff iimmaaggee gguuiiddeedd tteecchhnniiqquueess hhaass rreeaacchheedd aa hhiigghh lleevveell aass tthhee aaccccuurraacciieess tthhaatt ccaann bbee aacchhiieevveedd tteecchhnniiccaallllyy mmeeeett tthhee aannaattoommiiccaall ddeemmaannddss
  21. 21. HHoowweevveerr tthheerree iiss eevviiddeennccee tthhaatt tthhee iinntteerraaccttiioonn bbeettwweeeenn tthhee ssuurrggeeoonn ((hhuummaann ffaaccttoorr)) aanndd tthhee nnaavviiggaattiioonn ssyysstteemm iiss aa ssoouurrccee ooff iinnaaccccuurraaccyy