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Spine's Imaging Potential
Minimally invasive techniques have raised the demand for quality imaging.
Amir Vokshoor, Robert Bray
Publish Date: November 17, 2007   |  Tags:   Neurosurgery-Spine

Quality imaging is essential to navigating the spine during surgery. The small margin of error that minimally invasive techniques allow has heightened the need for more refined images. A successful spine facility will need a quality C-arm, fluoroscopy unit and radiolucent surgical tables. Fluoroscopy provides surgeons with a 2-D image of the targeted area. Intraoperative CT scanning offers a 3-D picture of the patient's anatomy and is ideal for more complex spine cases. Digital ORs, meanwhile, offer a glimpse into the not-so-distant future of spine imaging.

The digital revolution is here to stay and high-tech ORs are becoming an integral part of facility makeovers. Consider the possibilities for spine procedures. Localization of intraoperative films is performed much faster and more precisely with digital-based computed radiography than by shooting images onto plain films.

ORs are completely integrated; data and images are fed directly into the room's computer system. Any member of the surgical team can track the surgeon's progress as information and images are transmitted seamlessly throughout the clinical area. The OR tech and anesthesiologist each have their own high-resolution screen positioned on a boom system and can directly control which feed they watch. The circulating nurse controls the archiving of case information, including direct real-time printouts of CT images.

Information can be packaged for data archiving or transmitted within the surgical center or to a conference room at a remote site. Images can even be captured and set for Internet transmission, a feature currently limited only by broadband capability. Computed radiography reviews and C-arm imaging can also be used after surgery for pain management cases and for intra-articular injections in CT and MRI suites.

Every piece of equipment ??" the microscope, digital cameras, overhead lights, room overview cameras, C-arms, electrophysiology recording lights, sound system and, yes, the surgeon's iPod — are centrally controlled.

It's sometimes amazing that all this technology actually works. The build-out to accomplish the digital OR layout is involved and needs to be planned both before and during construction of a new facility. Miles of cable and fiber optics need to be laid within the walls and a great deal of thought is required to ensure every monitor is placed for ideal viewing by each member of the surgical team. You also have to decide which information and images you want to capture and how you want to use them. But if the digital OR is well planned, it will maximize your patient flow and spine case efficiency.

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