Computer Guidance for Spine Surgeons during Neck FusionWays to fuse the cervical spine (the spine in the neck) continue to improve as technology changes. A computer-assisted surgery (CAS) system is now in use.
Doctors in Germany report on their success using the CAS system. They used screws to hold the cervical vertebrae in place until the fusion was solid. Infrared cameras attached to the surgical tools gave the surgeons a clear view on a computer monitor during the operation.
There can be problems with this operation because of the small size of the bone where the screws go in. Damage to the nerves and blood vessels is possible. In this study, 19 patients had surgical screws inserted through the bones in the back part of the cervical spine. When the operation is done through the back of the neck, it is called posterior cervical fusion.
The advantage to using screws is the ability to reposition them. They also take less time to put in place. This makes the surgery shorter, with less blood loss. The CAS system measures the bone and chooses the right size of hole for the screw. The computer keeps the drill from going all the way through the bone.
The surgeons checked the position of the screws after surgery using images from a CT scan. None of the screws was misplaced. There were no injuries to the nerves, blood vessels, or bones. None of the screws had to be removed, replaced, or repositioned.
The CAS system has been in use for fusion of the low back since 1993. This study shows it can be used safely for posterior cervical fusion. The screws are placed in the right place without injury to the nearby structures. The authors conclude the CAS system makes a good spine surgeon even better.
Marcus Richter, et al. Computer-Assisted Posterior Instrumentation of the Cervical and Cervico-Thoracic Spine. In European Spine Journal. February 2004. Vol. 13. No. 1. Pp. 50-59.
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