Spinal diseases and malformations are becoming more widespread than ever before due to poor lifestyle choices, stressful living, and likely genetic factors. In addition, India has an alarmingly high number of cases of spinal injuries and tumors each year. Operating on the spine, on the other hand, is one of the most difficult surgery a surgeon can do.
The arduous undertaking, as explained by HS Chhabra, a renowned orthopaedic spine surgeon and medical director cum chief of spine services at the Indian Spinal Injuries Centre (ISIC) in New Delhi:
“The spine, which serves as the body’s central support structure, has 31 pairs of spinal nerves: eight cervical, twelve thoracic, five lumbar, five sacral, and one coccygeal, each of which connects the spinal cord to a different part of the body. When you add in additional typical surgical and post-surgical issues, you can see how dangerous a spine surgery can be.”
Minimally invasive spine procedures are becoming safer and more precise than ever before because to advances in technology and technical capabilities. According to Chhabra, spine surgery has improved in terms of patient outcomes with the introduction of the robots technology. “The spine robotics interface with the O-arm is the most recent development that can assist surgeons improve results and precision for patients, resulting in less discomfort, a faster recovery, and a lower risk of revision surgery,” he says.
What is O-arm?
With its innovative design, the O-arm enables complete 360-degree 3-D imaging during spine procedures. It is tailored to the needs of spine and orthopedic procedures, lowering the likelihood of a revision procedure. The O-arm not only delivers high-definition real-time intraoperative imaging of a patient’s anatomy, but also a wide field-of-view in two and three dimensions. Internally rotating around the patient on an operating table in 360 degrees with 6-degrees of freedom, the retractable O-arm can take a 2D or 3D image of the area to be operated on. As a result, the surgeon may see the patient’s anatomy from every angle.
Aside from high-definition real-time imaging, the O-arm provides numerous workflow advantages that make the surgeon’s job easier, minimize OT stress, and boost confidence. “For starters, operating room personnel may use the O-arm in the same way they would a C-arm with the robotic positioning system, making it very simple for the surgical team,” says the researcher. explains ISIC’s senior surgeon. “Second, the imaging procedure takes only 13 seconds. O-arm also allows for the most optimal dose without sacrificing image quality, thanks to a variety of dosage options. Finally, the O-arm is completely portable and can be transported from one operating room to another for simultaneous use.”
Why O-arm and robotics at ISIC?
“We get a lot more sophisticated and revision situations because of ISIC’s reputation than a regular multi-specialty facility. In addition, we have a high volume of spine surgery “Chhabra adds. He emphasizes that if there is a complication, the imaging must be increased. While a standard pre-operative CT scan can aid in diagnosis, it is done with the patient facing up, whereas surgery is frequently performed with the patient facing down or sideways. As a result, even with minor difficulties, anatomical shift occurs, meaning that the relative position of anatomical structures as shown on pre-operative CT differs from the relative position after surgery. This can make a surgeon’s task more difficult.
He emphasizes, “This is where engineering and technology address the problem: O-arm with Mazor X S.E. Robotic system.”
When O-Arm is used in conjunction with the Mazor Robotic system, the ecosystem benefits. The two technologies have been developed to work in tandem. As a result, the image captured by the O-Arm may be sent to the robotic system with a single button press, and the patient registration process is completely automated. This not only saves time but also eliminates the possibility of human error. Furthermore, because the image was obtained during surgery, the anatomical structures in the image are in the same relative position as the patient on the table.
“With this image, an experienced surgical team can swiftly construct the most optimal plan utilizing the robotic system’s advanced planning capabilities, execute this plan using robotic precision, all while visualizing with the Mazor X S.E. robotic system’s navigation features,” he continues. “Finally, using the O-arm, we may conduct a confirming scan right before the procedure is completed.” With the position memory feature, we may robotically guide the O-arm to the same location at the push of a button to check implant position. As a result, there is no need to wait for a post-operative CT scan to validate the surgical objectives. If any corrections are required, they can be made during the same procedure, potentially saving time and money.
O-arm robotic surgery improves patient outcomes not only in routine surgeries, but also in severe deformity surgeries, cervical spine surgeries, safeguarding important veins in the neck, and a variety of other complex spinal procedures.