The O-arm Surgical Imaging System provides real-time, high quality 2D and 3D intra-operative imaging of a patient's anatomy during orthopaedic surgeries using a breakable O-shaped gantry ring. It offers advantages over 2D imaging like increased accuracy through 3D navigation after acquiring multiple fluoroscopic images via cone beam CT rotation around the patient. The reconstructed images are transferred to an image-guided system, registering the patient's anatomy for navigation. Key benefits of the O-arm include the ability to image multi-planar views and multiple levels with less radiation exposure compared to conventional fluoroscopy, improving screw placement accuracy.

1. O- Arm

2. Introduction:-
• The O-arm Surgical Imaging System is a surgical imaging platform
designed for use in orthopaedic surgeries.
• It provides real-time, intra-operative imaging of a patient’s anatomy
with high quality images and a large field-of-view in both 2D and 3D.
• It has a breakable O shaped gantry ring. There is a segment that can
fully or partially detach from the ring to provide an opening for the
object to be imaged

4. • 2D imaging systems uses Anteroposterior and lateral images
incorporated with preop CT – Less Accurate
• 3D navigation – of cone beam CT enabled multiple fluoroscopic
image acquisition by a device that rotated isocentrically around the
patient – More Accurate

5. • Reconstructed images from is transferred to an image – guided
system for navigation.
• As the reference arc is tracked with patient imaging, the computer
generated 3D image of the patients operative field is already
registered and ready for use with navigation.

6. Advantages of 3D Navigation system O- arm:-
• Ability to image multi planar images, multiple levels in single
sequence.
• Efficacy in imaging of cervico-dorsal junction and upper thoracic spine
than conventional fluoroscopy.
• Decreased radiation exposure.
• Improved accuracy because the patients anatomy is registered in the
surgical position
• Imaging accuracy in patients who had undergone prior spine surgeries
at the same levels.
• Portability of the system.

7. • Intraoperative 3D imaging helps in correction of malplacement of
screws and avoidance of second surgery.
• Allow the application of minimally invasive approaches without
elevating the risk of implant misplacements, and thus help to
decrease skeletomuscular surgical trauma and ultimately the length
of hospital stay of patients.

8. Multi planar imaging:-
• Axial, sagittal and oronal images
• Multiple level imaging without moving the machine in single
sequence
• Imaging of cervicodorsal junction and upper thoracic spine.

9. • Free hand technique will only be safe and accurate when it is in hand
of an experienced surgeon.
• Accuracy of screw placement with O arm can reach 100%. The
learning curve of O- arm is high when compared to the free hand
technique which has a steep learning curve

10. Reduces Surgery time:-
• Placing and checking every screw with c-arm takes significant time
• Revising one misplaced screw can take as long as 20 minutes
• Misplacement rates have been reported to range from 5 to 41% in
lumbar spine and from 3 to 55% in thoracic spine using conventional
techniques.
• Complications associated with the technique of pedicle screw fixation. A selected
survey of ABS members. 1993 Nov;18(15):2231-8; discussion 2238-9.
doi: 10.1097/00007632-199311000-00015.

11. Uses:-
• Spine surgery procedures
• Cervical fusion
• Lumbar fracture and fusion
• Deformity correction
• Assessment of pedicle screw position
• Pelvic trauma and ankle fractures
• Kyphoplasty
• Cranial neurosurgery