TY - JOUR
T1 - Videoexoscopic real-time intraoperative navigation for spinal neurosurgery
T2 - a novel co-adaptation of two existing technology platforms, technical note
AU - Huang, Meng
AU - Barber, Sean Michael
AU - Steele, William James
AU - Boghani, Zain
AU - Desai, Viren Rajendrakumar
AU - Britz, Gavin Wayne
AU - West, George Alexander
AU - Trask, Todd Wilson
AU - Holman, Paul Joseph
N1 - Funding Information:
Methodist Institute of Technology, Innovation, and Education (MITIE) Laboratory space and personnel, cadaver procurement and handling, and Medtronic hardware including Stealth S7 station, O-Arm, and image-guided instruments were funded by Medtronic as part of a prescheduled regional product demonstration. They granted us unconditional access to one specimen and all tools necessary to conduct this specific study outside of their immediate product demonstration.
Publisher Copyright:
© 2017, Springer-Verlag London Ltd.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Image-guided approaches to spinal instrumentation and interbody fusion have been widely popularized in the last decade [1–5]. Navigated pedicle screws are significantly less likely to breach [2, 3, 5, 6]. Navigation otherwise remains a point reference tool because the projection is off-axis to the surgeon’s inline loupe or microscope view. The Synaptive robotic brightmatter drive videoexoscope monitor system represents a new paradigm for off-axis high-definition (HD) surgical visualization. It has many advantages over the traditional microscope and loupes, which have already been demonstrated in a cadaveric study [7]. An auxiliary, but powerful capability of this system is projection of a second, modifiable image in a split-screen configuration. We hypothesized that integration of both Medtronic and Synaptive platforms could permit the visualization of reconstructed navigation and surgical field images simultaneously. By utilizing navigated instruments, this configuration has the ability to support live image-guided surgery or real-time navigation (RTN). Medtronic O-arm/Stealth S7 navigation, MetRx, NavLock, and SureTrak spinal systems were implemented on a prone cadaveric specimen with a stream output to the Synaptive Display. Surgical visualization was provided using a Storz Image S1 platform and camera mounted to the Synaptive robotic brightmatter drive. We were able to successfully technically co-adapt both platforms. A minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) and an open pedicle subtraction osteotomy (PSO) were performed using a navigated high-speed drill under RTN. Disc Shaver and Trials under RTN were implemented on the MIS TLIF. The synergy of Synaptive HD videoexoscope robotic drive and Medtronic Stealth platforms allow for live image-guided surgery or real-time navigation (RTN). Off-axis projection also allows upright neutral cervical spine operative ergonomics for the surgeons and improved surgical team visualization and education compared to traditional means. This technique has the potential to augment existing minimally invasive and open approaches, but will require long-term outcome measurements for efficacy.
AB - Image-guided approaches to spinal instrumentation and interbody fusion have been widely popularized in the last decade [1–5]. Navigated pedicle screws are significantly less likely to breach [2, 3, 5, 6]. Navigation otherwise remains a point reference tool because the projection is off-axis to the surgeon’s inline loupe or microscope view. The Synaptive robotic brightmatter drive videoexoscope monitor system represents a new paradigm for off-axis high-definition (HD) surgical visualization. It has many advantages over the traditional microscope and loupes, which have already been demonstrated in a cadaveric study [7]. An auxiliary, but powerful capability of this system is projection of a second, modifiable image in a split-screen configuration. We hypothesized that integration of both Medtronic and Synaptive platforms could permit the visualization of reconstructed navigation and surgical field images simultaneously. By utilizing navigated instruments, this configuration has the ability to support live image-guided surgery or real-time navigation (RTN). Medtronic O-arm/Stealth S7 navigation, MetRx, NavLock, and SureTrak spinal systems were implemented on a prone cadaveric specimen with a stream output to the Synaptive Display. Surgical visualization was provided using a Storz Image S1 platform and camera mounted to the Synaptive robotic brightmatter drive. We were able to successfully technically co-adapt both platforms. A minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) and an open pedicle subtraction osteotomy (PSO) were performed using a navigated high-speed drill under RTN. Disc Shaver and Trials under RTN were implemented on the MIS TLIF. The synergy of Synaptive HD videoexoscope robotic drive and Medtronic Stealth platforms allow for live image-guided surgery or real-time navigation (RTN). Off-axis projection also allows upright neutral cervical spine operative ergonomics for the surgeons and improved surgical team visualization and education compared to traditional means. This technique has the potential to augment existing minimally invasive and open approaches, but will require long-term outcome measurements for efficacy.
KW - Image-guided surgery
KW - Medtronic stealth
KW - Real-time navigation
KW - Synaptive brightmatter drive
UR - http://www.scopus.com/inward/record.url?scp=85021259271&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85021259271&partnerID=8YFLogxK
U2 - 10.1007/s11701-017-0721-1
DO - 10.1007/s11701-017-0721-1
M3 - Article
C2 - 28656505
AN - SCOPUS:85021259271
SN - 1863-2483
VL - 12
SP - 251
EP - 255
JO - Journal of Robotic Surgery
JF - Journal of Robotic Surgery
IS - 2
ER -