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Cone Beam Intraoperative Computed Tomography-based Image Guidance for Minimally Invasive Transforaminal Interbody Fusion
Published on: August 6, 2019
Kyphoplasty: Traditional imaging compared with computer-guided intervention-time to rethink technique?
Michael P Silverstein1, Michael Mac Millan, Isador H Lieberman
1Florida State University, College of Medicine, Tallahassee, FL, USA.
Evidence-Based Spine-Care Journal
|April 2, 2013
Summary
Computer-guided kyphoplasty using cone-beam CT significantly reduces surgeon radiation exposure compared to fluoroscopy. Both methods demonstrate comparable accuracy and procedure times for pedicle cannula placement.
Area of Science:
- Spinal Surgery
- Medical Imaging
- Radiation Safety
Background:
- Kyphoplasty is a procedure to treat vertebral compression fractures.
- Traditional fluoroscopic guidance involves significant radiation exposure for surgeons and patients.
- Advancements in medical imaging offer potential for reduced radiation exposure.
Purpose of the Study:
- To compare computer-guided (cone-beam CT) kyphoplasty with traditional fluoroscopic kyphoplasty.
- To evaluate differences in surgeon and cadaver radiation exposure.
- To assess cannula placement accuracy and procedure time.
Main Methods:
- An equivalence trial was conducted on two cadavers.
- Kyphoplasty was performed using either cone-beam CT navigation or fluoroscopic guidance.
- Radiation exposure was measured using dosimeters on the surgeon and cadaver; procedure time and cannula position were recorded.
Main Results:
- Cone-beam CT resulted in 0.0 mrem surgeon radiation exposure, versus 5 mrem for fluoroscopy.
- Cadaver radiation exposure was 0.52 rads for cone-beam CT and 0.047 rads for fluoroscopy.
- Procedure times were similar, and both methods achieved accurate cannula placement without malposition.
Conclusions:
- Computer-guided kyphoplasty with cone-beam CT is as accurate as fluoroscopy.
- This technique effectively eliminates surgeon radiation exposure.
- Patient radiation levels with cone-beam CT are within acceptable limits.
