Article Figures & Data
Figures
- Figure 1
Patient flow diagram. 2D, 2-dimensional; 3D, 3-dimensional.
- Figure 2
Intraoperative views of the O-arm setup. (A) Standard drape with a patient frame inside the posterior iliac crest for navigation. (B) Infrared detectors on the O-arm machine.
- Figure 3
Intraoperative views of the Surgivisio setup. (A) Anteroposterior radiograph, which was taken with the detector placed on the patient (B). (C) The detector is replaced by the patient frame, allowing navigation procedures. (D) Setup of the Surgivisio device for imaging acquisitions.
- Figure 4
Intraoperative views of an instrumentation extension at the S1 level using the O-arm guidance. (A) Screen of the StealthStation with the 3-dimensional scan of the patient on sagittal and axial views, the navigated tool (in this case the screwdriver) and the screw with its determined length and diameter. (B) Intraoperative view of the navigated screwdriver during pedicle screw insertion.
- Figure 5
Intraoperative views of a Surgivisio procedure for pedicle screw insertion. (A) Screen of the Surgivisio, displaying the 3D scan of the patient with the trajectory of the navigated Jamshidi needle. (B) Nitinol threads for percutaneous pedicle screw insertion performed under Surgivisio guidance.
Tables
Variable O-Arm Group Surgivisio Group P Sex ratio, men/women 20/30 20/30 >0.99 Age, y, mean ± SD (range) 71 ± 10 (40–85) 64 ± 13 (29–92) 0.02 BMI, mean ± SD (range) 27 ± 4 (20–42) 26 ± 5 (18–40) 0.40 Abbreviations: BMI, body mass index; SD, standard deviation; y, years.
Note: Boldface indicates statistically significant findings.
Variable O-Arm Group Surgivisio Group P No. of instrumented vertebrae 120 145 <0.01 Thoracic vertebrae, n (%) 17 (14) 46 (32) Lumbar vertebrae, n (%) 103 (86) 68 (78) No. of operated vertebrae per patient, mean ± SD (range) 2.4 ± 1.14 (1–6) 2.9 ± 1.11 (2–6) 0.03 Operative time, min, mean ± SD (range) 145 ± 61 (60–410) 139 ± 73 (39–374) 0.68 Operative time per level, min, mean ± SD (range) 71 ± 45 (25–250) 53 ± 27 (15–125) 0.02 Operative time per screw, min, mean ± SD (range) 39 ± 23 (13–125) 27 ± 16 (8–94) <0.01 Percutaneous procedures, n (%) 5 (10) 39 (78) <0.01 Open procedures, n (%) 45 (90) 11 (22) Revisions, n (%) 23 (46) 7 (14) <0.01 Note: Boldface indicates statistically significant findings.
Classification Group O-Arm Surgivisio Heary I 36 58 II 1 14 II 0 4 IV 1 6 V 0 0 Total No. of thoracic screws 38 82 Gertzbein A 179 170 B 10 23 C 1 3 D 0 2 E 0 4 Total No. of lumbar screws 190 202 Variable Group, mean ± SD (range) P O-Arm Surgivisio 2D imaging duration, sec 4 ± 3 (1–19) 109 ± 45 (37–250) <0.01 No. of 3D acquisitions/patient 1.1 ± 0.27 (1–2) 1.6 ± 0.83 (1–5) <0.01 DLP, mGy.cm 345 ± 161 (88–837) - - Overall DAP, mGy.cm2 - 9664 ± 6978 (2000–29,276) - DAP related to 2D, mGy.cm2 1167 ± 1111 (181–5645) 4209 ± 4042 (406–25,365) <0.01 Overall E, mSv 5.43 ± 2.53 (1.42–13.20) 2.70 ± 2.32 (0.60–12.74) <0.01 E per level, mSv 2.65 ± 1.46 (0.52–6.88) 1.02 ± 0.87 (0.15–3.87) <0.01 E 2D, mSv 0.26 ± 0.24 (0.04–1.41) 1.16 ± 1.18 (0.12–6.88) <0.01 E 3D, mSv 5.17 ± 2.42 (1.23–12.56) 1.54 ± 1.47 (0.33–8.54) <0.01 E per 3D acquisition, mSv 4.79 ± 2.03 (1.23–12.56) 0.90 ± 1.06 (0.11–6.60) <0.01 E 2D calculated with w, mSv 0.30 ± 0.29 (0.05–1.47) 1.05 ± 1.06 (0.11–6.60) <0.01 AR, % 2.7 × 10−4 ± 1.3 × 10−4 (6.4 × 10−5 to 6.7 × 10−4) 1.4 × 10–4 ± 1.2 × 10−4 (3.0 × 10−5 to 6.3 × 10−4) <0.01 Abbreviations: AR, absolute risk of radiation-induced cancer; 2D, 2-dimensional; 3D, 3-dimensional; DAP, dose area product; DLP, dose length product; E, effective dose.
Note: Boldface indicates statistically significant findings.
Variables Compared O-Arm Group Surgivisio Group Overall r Value (95% CI) P r Value (95% CI) P r Value (95% CI) P E and age −0.37 (−0.59; −0.10) <0.01 0.25 (−0.03; 0.50) 0.08 0.12 (−0.08; 0.31) 0.25 E and BMI 0.17 (−0.12; 0.43) 0.25 0.01 (−0.27; 0.29) 0.94 0.12 (−0.08; 0.31) 0.24 E and operative time 0.23 (−0.05; 0.48) 0.11 0.03 (−0.25; 0.30) 0.85 0.13 (−0.07; 0.32) 0.21 E and operative time per level −0.11 (−0.38; 0.17) 0.45 −0.08 (−0.35; 0.21) 0.60 0.04 (−0.16; 0.23) 0.73 E 2D and operative time 0.15 (−0.14; 0.41) 0.31 −0.01 (−0.29; 0.27) 0.95 −0.01 (−0.21; 0.19) 0.93 E 2D and operative per level −0.11 (−0.38; 0.17) 0.45 −0.00 (−0.28; 0.28) 0.98 −0.13 (−0.32; 0.07) 0.20 E and imaging duration 0.40 (0.14; 0.61) <0.01 0.27 (−0.01; 0.51) 0.06 −0.33 (−0.50; −0.15) <0.01 E 2D and imaging duration 0.78 (0.63; 0.87) <0.01 0.20 (−0.09; 0.45) 0.18 0.49 (0.33; 0.63) 0.33 E 2D and E 3D 0.39 (0.12; 0.60) <0.01 0.53 (0.30; 0.71) <0.01 −0.10 (−0.29; 0.10) 0.33 Abbreviations: BMI, body mass index;2D, 2-dimensional; 3D, 3-dimensional; E, effective dose.
Note: Boldface indicates statistically significant findings.
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