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Electromagnetic navigation for percutaneous guide-wire insertion: accuracy and efficiency compared to conventional
R A von Jako1, J A Carrino, K S Yonemura
1GE Healthcare Surgery, 439 S. Union St., Lawrence, MA 01843, USA. drvonjako@comcast.net
Neuroimage
|May 12, 2009
Summary
Electromagnetic (EM) navigation combined with fluoroscopy offers accurate pedicle guide-wire placement in spinal surgery. This EM image-guided surgery (IGS) system reduces placement and fluoroscopy times compared to conventional methods.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Medical Imaging
Background:
- Intraoperative fluoroscopy is standard in spinal surgery.
- Image-guided surgery (IGS) systems enhance localization accuracy.
- Electromagnetic (EM) navigation offers a novel approach to IGS.
Purpose of the Study:
- To assess the accuracy and time efficiency of EM navigation versus conventional fluoroscopy for pedicle guide-wire placement.
- To compare setup, placement, and fluoroscopy times between EM-based IGS and conventional fluoroscopy.
- To evaluate the rate of cortical breaches and trajectory accuracy.
Main Methods:
- Kirschner wire (K-wire) placement was performed in cadavers from T8 to S1.
- EM navigation was compared against conventional fluoroscopy.
- Accuracy was assessed via CT imaging, and time metrics were recorded.
Main Results:
- K-wire placements were 100% successful with both methods.
- EM navigation showed longer setup times (9.6 min vs. 3.6 min) but shorter mean placement (6.3 min vs. 9.7 min) and fluoroscopy times (11 s vs. 48 s).
- No significant differences in cortical breaches were observed, but EM navigation yielded a higher proportion of ideal trajectories.
Conclusions:
- EM navigation is an effective alternative to conventional fluoroscopy for spinal surgery.
- EM IGS systems facilitate accurate pedicle screw insertion with reduced fluoroscopy time.
- This technology aids minimally invasive spinal procedures by improving trajectory accuracy.
