Use of O-arm With Intraoperative Arteriography for Localization and Stealth Navigation of the Vertebral Arteries During Posterior Cervical Spine Surgery

J. Willis Kiessling; Ajay Ramnot; Tiffany Odell; Yasir Khan; Deependra Mahato

doi:10.14444/7158

Article Figures & Data

Figures

Download figure
Open in new tab
Download powerpoint
Figure 1
(Left) Sagittal computed tomography (CT) cervical spine demonstrating anterior inferior C2 vertebral body fracture. (Right) Coronal CT angiography of the neck with arrows demonstrating levels of right vertebral artery injury at C2 and C6.
Download figure
Open in new tab
Download powerpoint
Figure 2
Correlation of finding of vascular structure (A and B) intraoperatively. O-arm imaging showing both axial (C) and sagittal (D) navigation. Dashed blue line is C1 posterior arch, dashed yellow line is C2 body, and dashed white line is vascular structure.
Download figure
Open in new tab
Download powerpoint
Figure 3
Examples of intraoperative navigation after intraoperative arteriography to find location of the vertebral artery.
Download figure
Open in new tab
Download powerpoint
Figure 4
Three-dimensional (3D) reconstructions performed with O-arm intraoperatively displaying vertebral artery course. (A) Original 3D reconstruction on O-arm. (B and C) Progressive intraoperative image alterations made so as to see the entire course of the vertebral arteries with the cervical spine. (D) In comparison with the intact, dominant, left vertebral artery, the injured right vertebral artery and its course are imaged. (E) Once again, the entire course of the right vertebral artery can be merged and reconstructed from the O-arm arteriography. (F) High-resolution reconstruction showing the course of the left vertebral artery in the upper cervical spine.