All-in-one intraoperative 3D imaging and navigation on percutaneous vertebroplasty. Preliminary results on the first 51 patients

6 pages•Published: October 26, 2019

Jérôme Tonetti, Mehdi Boudissa, Gael Kerschbaumer and Marc Prod'Homme

Abstract

Vertebroplasty (VP) is the gold standard for vertebral compression fracture (VCF) treatment. VP could be improved by using intra operative cone bean computed tomography (CBCT) although duration is largely increased. We report first series of 51 patients whom underwent VP integrating intraoperative navigation to CBCT, in order to cut down time consumption. During a 8 month period, 51 patients were prospectively enrolled. The mean age was 71 years old (36-94). There were 17 male and 35 female. We stored 65 VP (14 thoracic and 51 lumbar). After percutaneous pins fixation to the spinous process of the “Butterfly” acquisition reference frame, 180° rotation of the C-arm CBCT (Surgivisio®, eCential, Grenoble France) generated a 3D volume. Optically localized, sterile self- calibrated trocar was navigated in order to reach the vertebral body center by an unilateral pedicular approach. Cement (Vertaplex HV®, Stryker) was injected under fluoroscopic lateral view by the same machine, using standard 2D X-ray modes. Considering the 38 patients who underwent 1 level VP, mean time procedure was 00:30:09 [00:21:00 to 00:54:00; SD 00:10:23]. The mean DAP was 5,41318 Gy.cm2 and mean exposure duration 3,68 seconds. The mean efficient dose (E) was 1,32 mSv. In all cases cement placement was classified as excellent or mild, without any leakage. This new C-arm CBCT with integrated navigation is efficient to dramatically decrease operating time in comparison to literature (00:46:00 to 00:52:08). The reduction of radiation dose is already demonstrated in literature for navigated VP.

Keyphrases: integrated navigation, intraoperative cbct, time saving, vertebroplasty

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 370-375.

Links:	https://easychair.org/publications/paper/s2rH
	https://doi.org/10.29007/w6d6

BibTeX entry

@inproceedings{CAOS2019:All_one_intraoperative_3D,
  author    = {Jérôme Tonetti and Mehdi Boudissa and Gael Kerschbaumer and Marc Prod'Homme},
  title     = {All-in-one intraoperative 3D imaging and navigation on percutaneous vertebroplasty. Preliminary results on the first 51 patients},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/s2rH},
  doi       = {10.29007/w6d6},
  pages     = {370-375},
  year      = {2019}}

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