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A D V A N C E D
I M A G I N G
and in use, there are 3 — I wouldn't call them drawbacks — but key considerations.
• Expansion. We don't do the 3D spins as often as we thought we would
when we first got it, and physicians were bickering over who got to use
the shiny new toy for their procedures. As it turns out, for the most part,
they feel comfortable with their surgical techniques and "feeling out"
hardware placements. But they do like the backup of reassurance when
it's needed, in more complex anatomy or during a difficult procedure.
In the future, I think we'll get expanded use out of the 3D C-arm when
it's used in collaboration with a navigation system, which we're shopping
for now. Having a computer-aided surgery system in place will let us do
the initial 3D spin, render the images, and then let the surgeon work in
real time, watching his progress on the flat-panel monitor. He'll be able
to see where the instruments are, how far the screws are going into the
bones and the pedicle placement. We won't have to X-ray again; everything will come from the navigation system.
• Radiation exposure. The scan takes under a minute with the 3D C-arm
but, if anything, it's longer than with 2D imaging. So you're probably
exposing the patient to more radiation, but it's not even close to a harmful dose. These systems come with targeted dosing control, to minimize
the radiation dose used, which protects patients and staff alike. So the
low increase in radiation (and in time under anesthetic) is outweighed
by the benefits in data acquisition, generating individual multiplanar
reconstructions, hardware placement and surgeon peace of mind.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2013
