Ganga hospital is the only center in country and one of the few centers
in world performing Iso-C based navigation surgeries in spine. The
institute has been performing computer navigated surgeries in
complex spine disorders since 2004. Computer Navigation is a new
innovative technology in spine surgeries, which improves the
intraoperative accuracy. It allows virtually any surgical instrument to
be tracked in reference to the displayed anatomy in real time. This can
be particularly helpful when a spine surgeon places an instrument or
implant into unexposed or partially exposed spinal structures that
may not be directly visible, such as the pedicle or vertebral body.
The navigation system available in our institute comprises of a
Computer workstation (Vector vision compact, BrainLAB-AG,
3D 3D
Germany) and Iso-C C-arm (Siremobil Iso-C ; Siemens Medical
3D
Solutions, Erlangen, Germany) . Iso-C C-arm based navigation has
several advantages over conventional CT based systems. The Iso-
C-arm provides three-dimensional reconstructed images of the
patient on the operating table. Therefore, the risk of navigation
inaccuracy due to intervertebral alignment differences between the
preoperative CT data set and the intraoperative position is eliminated.
The images acquired by Iso-C are automatically transferred to
computer-workstation; thus obviating the need for separate time
consuming registration.
Patient with C1-C2 instability operated using computer navigation
Accurate placement of cervical pedicle screws
We have been regularly using computer
navigation in various spine surgeries and have particularly found it to
be extremely useful in deformity surgeries, cervical pedicle screw
fixations and vertebral tumor resection. Our institute has been
recognized as a research and reference centre for Computer
Navigated Surgery.
Related Publications
Rajasekaran S, Vidyadhara S, Ramesh Perumal, Ajoy P.Shetty,
Randomised clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws
in deformity correction surgeries. Vol 32, No.2, pp E56-E64, SPINE 2007.
Rajasekaran S, Kamath Vijay, Ajoy P Shetty.
Intraoperative Iso-C Three dimensional navigation in excision of spinal osteoid osteomas.
Ashish Jaiswal, Ajoy P Shetty, Rajasekaran S.
Role of Intraoperative Iso-C based navigation in challenging spine trauma.
Indian journal of Orthopaedics, Volume 41, Issue 4, Oct-Dec, 2007.
Rajasekaran S, Vidyadhara S, Ajoy P Shetty.
Iso-C 3D fluoroscopy based navigation in Direct Pedicle Screw fixation of Hangman Fracture
A Case report. J Spinal Disord Tech. 2007
Rajasekaran S, Vidyadhara S, Shetty AP.
3D
Intra-operative Iso-C navigation for pedicle screw instrumentation of hangman's fracture: a case report.
Journal of Orthopaedic Surgery 2007;15(1):737.
As science progresses, answers are being found for a majority of previously untreatable diseases. In the process new more dangerous ones are being recognized. With these advances surgery has become safe and much more common. Spine surgery too has seen an astronomical growth and surgeries for complex deformity have gone up. Computer navigated spine surgery is the most advanced tool in the spine surgeons’ armour in the quest towards perfection.
Prior to the advent of computer navigation, complex deformities were a nightmare for both the patient and the surgeon. Hardware related complications were the norm. The close proximity of the spinal cord and nerve roots and the altered and abnormal anatomy led to the rate of complications increasing manifold when compared to spine surgery on normal anatomy.
Computer navigation uses intra-operative fluoroscopic imaging to reconstruct spinal anatomy in reference to fixed sensor arrays. After the initial imaging sequence, the infra red sensor arrays help to guide the surgeon regarding 3 dimensional anatomy through which screw trajectories can be planned without damage to vital structures. This system is scientifically proven to improve accuracy rates of screw placement and allows placement of screws in challenging situations like the cervical spine pedicles and in scoliosis. Another advantage of this system is that it reduces the exposure time to rays from the fluoroscopy unit.
Ganga hospital was the first centre in the country to use computer navigation in spine surgery. In its commitment towards excellence in spine care, computer navigation is another feather in its cap. Ganga hospital has a multitude of publications in international journals regarding the use of navigation in difficult spine surgery. The quest for perfection continues and we strive towards better patient care. |
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