Intraoperative Computed Tomography in Orthopaedic Trauma Surgery.

Area of Science:

• Medical Imaging
• Surgical Technology
• Orthopedic Surgery

Background:

• Mobile 3D C-arms suffer from image quality impairments due to metal artifacts and limited field of view.
• Specialized intraoperative computed tomography (CT) devices have been developed to overcome these limitations.
• These CT devices aim to enhance image quality for intraoperative use.

Purpose of the Study:

• To analyze the practicability and benefits of a mobile intraoperative CT device (Airo).
• Evaluation based on parameters gathered over a 40-month period.
• Assessing its utility in surgical procedures.

Main Methods:

• Analysis of all procedures using intraoperative CT between January 2017 and April 2020.
• Data collected on anatomical region, scan count, scan duration, and navigation use.
• Consequences drawn from scan assessments were also analyzed.

Main Results:

• 354 CT scans were performed on 171 patients, with a mean of 2.07 scans per procedure.
• Procedures predominantly involved the spine (47.81%) and pelvis (52.19%).
• 83% of procedures utilized navigation; 22% showed improved implant placement, and 55% involved guidewire correction for pedicle screws.

Conclusions:

• Intraoperative CT use was reliable and beneficial, offering outstanding image quality for assessing implant placement.
• Integration into operating room standards requires more effort compared to mobile 3D C-arms.
• Recommended for intraoperative CT in spinal and pelvic trauma surgery in high-level trauma centers due to its effectiveness, despite high costs.