Research studies highlight advantages and potential of computer-guided spinal surgery

April 3, 2014, Cedars-Sinai Medical Center

In a series of research studies, Cedars-Sinai spinal surgeons show that a new method of computer-guided spine surgery is beneficial for spinal reconstruction and for treating complex tumors and degenerative spine problems, resulting in fewer complications and better outcomes for patients.

The Cedars-Sinai surgeons highlight the advantages of a "spinal navigation" technique that uses high-speed computerized tomography (CT) imaging to navigate in and around the spinal column from different angles. They present their findings in six articles published in the current issue of Neurosurgical Focus, an online peer-reviewed journal published by the American Association of Neurological Surgeons.

Investigators say the three-dimensional navigational method is a major improvement over traditional two-dimensional fluoroscopic X-rays. It allows surgeons to more precisely and accurately place reconstruction screws in the narrow bony corridors of the , avoiding nerves, blood vessels and other critical structures. This reduces or may even avoid complications, post-operative pain and the need for follow-up surgeries, they write.

"Computer-guided surgical navigation technology delivers on quality and safety," said J. Patrick Johnson, MD, a neurosurgery spine specialist and director of Spine Education and the Neurosurgery Spine Fellowship program in the Department of Neurosurgery. "It clearly improves outcomes in spine care."

The computerized navigation system uses a mobile CT-scanner to take cross-sectional images of the spine while a patient is in surgery. The images are transferred to a computer, which displays them on overhead monitors that allow precise tracking of surgical instruments as surgeons insert screws for reconstruction and perform other complex procedures on the spine.

Surgeons said the technique is superior to existing methods because of its precision and speed. They point out that even small miscalculations with two-dimensional technology can cause problems that require follow-up operations because hardware was initially out of place. The Cedars-Sinai surgeons say they have cut these to nearly zero by using computer-guided methods.

The surgeons said the technology has others applications for treating spinal disorders, serving as a tool to remove tumors, decompress the spinal column and perform minimally-invasive surgery.

"This approach represents a major leap forward for instrumented ," said Terrence T. Kim, MD, an orthopedic spine surgeon in the Cedars-Sinai Spine Center and expert in the computer-guided navigation field. "We're looking at the future."

Joining Drs. Johnson and Kim as study co-authors are Doniel Drazin, MD, a senior resident in the Department of Neurosurgery, and Robert S. Pashman, MD, a clinical associate professor and orthopedic spine surgeon at the Cedars-Sinai Spine Center.

The group's studies accounted for six of 10 articles in the March issue of Neurological Focus. A spokeswoman at the online journal said it is highly unusual for a single institution to publish a majority of articles in a single journal issue.

One of the Cedars-Sinai studies showed that the mobile CT-scanner and computer-aided system used during minimally invasive surgery increased the accuracy of screw placement into vertebral pedicle bones.

Another study found that the computerized navigation system and the mobile CT scanner allowed for more accurate surgical placement even within the narrowest parts of the thoracic spine, particularly challenging regions in women and children who have smaller vertebral pedicle bones than most men.

A third study determined that the image-guided technique can be useful for other minimally invasive procedures, including thoracic endoscopic spine surgery to remove tumors, infections and other conditions accessed through the chest cavity.

The final two articles offer an overview of computer-guided surgery of the spine, including its use in "revision" or "redo" spine surgeries that are often the most complex; and the potential future use of robotic spine surgery with computer navigation.

Explore further: Innovative 'false pedicle' surgery allows for advanced spinal/pelvic reconstruction

Related Stories

Innovative 'false pedicle' surgery allows for advanced spinal/pelvic reconstruction

March 27, 2014
A multidisciplinary team at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital & Richard J. Solove Research Institute (OSUCCC – James) has pioneered a new surgical technique using ...

Two spine surgeons are three times safer than one

March 26, 2014
A new team approach has improved safety—reducing rates of major complications by two thirds—for complex spinal reconstructive surgery for spinal deformity in adult Group Health patients at Virginia Mason Hospital & Seattle ...

New guidance system could improve minimally invasive surgery

March 27, 2014
Johns Hopkins researchers have devised a computerized process that could make minimally invasive surgery more accurate and streamlined using equipment already common in the operating room.

Minimally invasive spine surgery using real-time 3-D CT imaging allows patients to recover more quickly

January 15, 2013
(Medical Xpress)—With demand for unresolved back pain relief growing as the U.S. population ages, Rush University Medical Center is doing more minimally invasive spine surgery procedures that allow patients to return to ...

Model can predict spine surgery complications

January 31, 2014
(HealthDay)—A new model can predict the risk of medical complications, including major complications, after spine surgery, according to a study published in the Feb. 1 issue of The Spine Journal.

Recommended for you

Drug may help surgical patients stop opioids sooner

December 13, 2017
(HealthDay)—Opioid painkillers after surgery can be the first step toward addiction for some patients. But a common drug might cut the amount of narcotics that patients need, a new study finds.

Children best placed to explain facts of surgery to patients, say experts

December 13, 2017
Getting children to design patient information leaflets may improve patient understanding before they have surgery, finds an article in the Christmas issue of The BMJ.

Burn victim saved by skin grafts from identical twin (Update)

November 23, 2017
A man doomed to die after suffering burns across 95 percent of his body was saved by skin transplants from his identical twin in a world-first operation, French doctors said Thursday.

Is a common shoulder surgery useless?

November 21, 2017
(HealthDay)—New research casts doubt on the true effectiveness of a common type of surgery used to ease shoulder pain.

Study shows electric bandages can fight biofilm infection, antimicrobial resistance

November 6, 2017
Researchers at The Ohio State University Wexner Medical Center have shown - for the first time - that special bandages using weak electric fields to disrupt bacterial biofilm infection can prevent infections, combat antibiotic ...

Obesity increases incidence, severity, costs of knee dislocations

November 3, 2017
A new study of more than 19,000 knee dislocation cases in the U.S. between 2000 and 2012 provides a painful indication of how the nation's obesity epidemic is changing the risk, severity and cost of a traumatic injury.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.