Seminars in Spine Surgery
Volume 19, Issue 2 , Pages 78-86, June 2007

Intraoperative Imaging Techniques in Spine Surgery

  • Jaehon M. Kim, MD

      Affiliations

    • Weill Medical College of Cornell University, New York, NY.
    • ,
  • Andrea L. Bowers, MD

      Affiliations

    • Department of Orthopaedic Surgery, The University of Pennsylvania, Philadelphia, PA.
    • ,
  • Kingsley R. Chin, MD

      Affiliations

    • Department of Orthopaedic Surgery, The University of Pennsylvania, Philadelphia, PA.
    • Corresponding Author InformationAddress reprint requests to Kingsley R. Chin, MD, Assistant Professor of Orthopaedics, Department of Orthopaedic Surgery, University of Pennsylvania, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA 19104.

The conventional method of inserting pedicle screws (ie, plain radiography, standard 2D fluoroscopy, direct palpation) was found to be less accurate with cortical violation ranging from 10 to 50%. Small and variable anatomy of the cervical and thoracic spine poses a particular challenge, and it can lead to a devastating neurovascular complication. With recent advances in imaging technologies, such as computed tomography-based image guidance and isocentric C-arm fluoroscopy, surgeons are now able to visualize hidden pedicles and reduce screw misplacement. Using these various navigation systems, the rate of pedicle screw perforation can be decreased to less than 10% and potentially eliminate clinically significant complications and revision surgeries.

Keywords: intraoperative spine navigation, CT-based image guidance, isocentric C-arm fluoroscopy, virtual fluoroscopy, pedicle screws

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 No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.

PII: S1040-7383(07)00034-2

doi:10.1053/j.semss.2007.04.003

Seminars in Spine Surgery
Volume 19, Issue 2 , Pages 78-86, June 2007

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