Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion

10.3791/57830 ◽  
2019 ◽  
Author(s):  
Michael Safaee ◽  
Taemin Oh ◽  
Murat Pekmezci ◽  
Aaron J. Clark
Keyword(s):  
Computed Tomography ◽  
Minimally Invasive ◽  
Image Guidance ◽  
Interbody Fusion ◽  
Cone Beam ◽  
Intraoperative Computed Tomography ◽  
Transforaminal Interbody Fusion

Three-Dimensional Computed Tomography-Based Spinal Navigation in Minimally Invasive Lateral Lumbar Interbody Fusion: Feasibility, Technique, and Initial Results

2015 ◽  
Vol 11 (2) ◽  
pp. 259-267 ◽  
Author(s):  
Paul Park
Keyword(s):  
Computed Tomography ◽  
Minimally Invasive ◽  
Navigation System ◽  
Interbody Fusion ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Lumbar Interbody Fusion ◽  
Disk Space ◽  
Image Guided ◽  
Spinal Navigation

Abstract BACKGROUND As with most minimally invasive spine procedures, lateral lumbar interbody fusion (LLIF) requires the use of biplanar fluoroscopy for localization and safe interbody cage placement. Computed tomography (CT)-based intraoperative spinal navigation has been shown to be more effective than fluoroscopic guidance for posterior-based approaches such as pedicle screw instrumentation. However, the use of spinal navigation in LLIF has not been well studied. OBJECTIVE To present the technique for using an intraoperative cone-beam CT and image-guided navigation system in LLIF and to provide a preliminary analysis of outcomes. METHODS We retrospectively analyzed a prospectively acquired database and the electronic records of patients undergoing LLIF with spinal navigation. Eight patients were identified. Postoperative neurological deficits were recorded. All patients underwent postprocedural CT and x-ray imaging for analysis of accuracy of cage placement. Accuracy of cage placement was determined by location within the disk space. RESULTS The mean age was 66 years, and 6 patients were women. A mean 2.8 levels were treated with a total of 22 lateral cages implanted via navigation. All cages were placed within quarters 1 to 2 or 2 to 3, signifying the anterior half or middle portions of the disk space. There were no sensory or motor deficits postoperatively. CONCLUSION Use of an intraoperative cone-beam CT with an image-guided navigation system is feasible and safe and appears to be accurate, although a larger study is required to confirm these results.

Assessment of unintended shifts during frame-based stereotactic radiosurgery using cone beam computed tomography image guidance

2020 ◽  
Vol 148 (2) ◽  
pp. 273-279
Author(s):  
Danushka S. Seneviratne ◽  
Austin R. Hadley ◽  
Jennifer L. Peterson ◽  
Timothy D. Malouff ◽  
Ronald Reimer ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Stereotactic Radiosurgery ◽  
Cone Beam Computed Tomography ◽  
Image Guidance ◽  
Cone Beam ◽  
Tomography Image ◽  
Computed Tomography Image

Analysis of Intraoperative Cone-Beam Computed Tomography Combined With Image Guidance for Lateral Lumbar Interbody Fusion

2017 ◽  
Vol 14 (6) ◽  
pp. 620-626
Author(s):  
Xilin Liu ◽  
Jacob R Joseph ◽  
Brandon W Smith ◽  
Yamaan Saadeh ◽  
Paul Park
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Cone Beam Computed Tomography ◽  
Interbody Fusion ◽  
Cone Beam ◽  
Lumbar Interbody Fusion ◽  
Lateral Lumbar Interbody Fusion ◽  
Spinal Navigation ◽  
Male Patients ◽  
Biplanar Fluoroscopy

Abstract BACKGROUND Minimally invasive lateral lumbar interbody fusion (LLIF) is traditionally performed with biplanar fluoroscopy. Recent literature demonstrates that intraoperative cone-beam computed tomography combined with spinal navigation can be safely utilized for localization and cage placement in LLIF. OBJECTIVE To evaluate the accuracy and safety of cage placement using spinal navigation in LLIF, as well as to evaluate the radiation exposure to surgeon and staff during the procedure. METHODS The authors performed a retrospective analysis of a prospectively acquired database of patients undergoing LLIF with image-based navigation performed from April 2014 to July 2016 at a single institution. The medical records were reviewed, and data on clinical outcomes, cage accuracy, complications, and radiation exposure were recorded. All patients underwent a minimum 30-d clinical follow-up to assess intraoperative and short-term complications associated with their LLIF. RESULTS Sixty-three patients comprising 117 spinal levels were included in the study. There were 36 (57.1%) female and 27 (42.9%) male patients. Mean age was 62.7 yr (range 24-79 yr). A mean 1.9 (range 1-4) levels per patient were treated. Cages were placed in the anterior or middle of 115 (98.3%) disc spaces. Image-guided cage trajectory was accurate in 116/117 levels (99.1%). In a subgroup analysis of 18 patients, mean fluoroscopy time was 11.7 ± 9.7 s per level. Sixteen (25.4%) patients experienced a complication related to approach. CONCLUSION Use of intraoperative cone-beam computed tomography combined with spinal navigation for LLIF results in accurate and safe cage placement as well as significantly decreased surgeon and staff radiation exposure.

Cone beam computed tomography and its image guidance technology during percutaneous nucleoplasty procedures at L5/S1 lumbar level

2016 ◽  
Vol 45 (12) ◽  
pp. 1669-1676 ◽  
Author(s):  
Anna Maria Ierardi ◽  
Filippo Piacentino ◽  
Francesca Giorlando ◽  
Alberto Magenta Biasina ◽  
Alessandro Bacuzzi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Image Guidance ◽  
Cone Beam ◽  
Lumbar Level

scholarly journals Accuracy of Image Guidance Using Free-Breathing Cone-Beam Computed Tomography for Stereotactic Lung Radiotherapy

PLoS ONE ◽  
2015 ◽  
Vol 10 (5) ◽  
pp. e0126152 ◽  
Author(s):  
Takeshi Kamomae ◽  
Hajime Monzen ◽  
Shinichi Nakayama ◽  
Rika Mizote ◽  
Yuuichi Oonishi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Image Guidance ◽  
Free Breathing ◽  
Cone Beam ◽  
Lung Radiotherapy
Sign in / Sign up

Export Citation Format

Share Document