A P R I L 2 0 1 6 O U T P A T I E N TS U R G E R Y. N E T 5 9
screws and the bones are positioned exactly as they should be — while the
patient is still in the room. In 2 minutes, our fluoroscopy tech rotates the C-arm
around the patient, capturing CT-like images of our handiwork that spin in 3
planes — axial, sagittal and coronal — on the flat-screen monitor.
This is a tremendous leap forward in surgical imaging. Because I don't have to
wait for the results of a post-operative CT scan, I can make a correction, if nec-
essary, intraoperatively instead of scheduling a revision surgery or accepting a
suboptimal reduction to avoid a second anesthesia. Nothing lets surgeons con-
trol the radiographic outcome of their intervention and check the results of
their surgical technique like an intraoperative 3D scan.
As an orthopedic trauma surgeon at the University of Texas Health Science
Center at Houston, I've been using a 3D C-arm for a little more than a year. A 3-
dimensional device is best suited for intraoperative use in orthopedic and spine
surgery, as well as trauma cases, when precise imaging and perfect visualization
matter most.
Clinical utility
In trauma and orthopedic surgery, the precise identification and reduction of
fractures and the accurate placement of implants is often critical to clinical out-
comes. Several studies have demonstrated that CT scans are superior to 2D
imaging for detection of malreduction and malposition of implants.
Malpositioning of spinal implants can have devastating consequences, including
paralysis or damage to great vessels, including the aorta.
Take an ankle fracture with an associated syndesmotic injury, for example. On
"I can be certain that the screws and bones are positioned
as they should be — while the patient is still in the room."
— Joshua L. Gary, MD
