Usability and Accuracy assessment of an innovative low dose C-arm with 2D fluoroscopy, 3D imaging and real-time navigation in a single platform for spine surgery – a cadaveric experimentation

6 pages•Published: October 26, 2019

John Sledge, Stephane Lavallee, Sophie Genna and Laurence Chabanas

Abstract

Introduction
Clinical benefits of intra-operative 3D imaging and surgical navigation are widely described in the literature. However, existing guidance systems are often reported as complex and time consuming1,2,4. The Surgivisio / eCential system is an innovative intra-operative C-arm combining 2D fluoroscopy, 3D imaging and real time navigation capabilities within unified an all-in-one platform3.
The aim of this cadaveric experimentation is to evaluate the usability of the system, and to assess pedicle screw placement using this novel device.
Material and methods
Surgivisio / eCential device offers an all-in-one solution with a unique workflow and user interface. The embodiment used here is dedicated to any spinal procedures requiring insertion of a trocar inside a pedicle.
The usability of the system is assessed by measuring the ability of the user to navigate the trocar and place k-wires percutaneously inside a group of pedicles.
The accuracy of screw placement is evaluated using post-operative 3D image of the implanted screw exported on an internally developed image visualization tool. The screw placement is assessed according to Gertzbein grading scale by the operator and two other evaluators.
Results
Usability
For each vertebrae group, fixation of the patient reference to the end of 3D reconstruction was done in less than 10 minutes. The percutaneous navigation and placement of 6 k-wires in a vertebrae group could be performed in 28 minutes for the first 2 groups and in 22 minutes for the third group.
Pedicle screw implantation
100% of screws was graded 0 on Gertzbein scale by all evaluators.

Keyphrases: intra operative 2d/3d imaging, navigation, spine surgery, unified technologies

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 338-343.

Links:	https://easychair.org/publications/paper/nM74
	https://doi.org/10.29007/bmlj

BibTeX entry

@inproceedings{CAOS2019:Usability_Accuracy_assessment_innovative,
  author    = {John Sledge and Stephane Lavallee and Sophie Genna and Laurence Chabanas},
  title     = {Usability and Accuracy assessment of an innovative low dose C-arm with 2D fluoroscopy, 3D imaging and real-time navigation in a single platform for spine surgery – a cadaveric experimentation},
  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/nM74},
  doi       = {10.29007/bmlj},
  pages     = {338-343},
  year      = {2019}}

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