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o-arm

O-arm® Surgical Imaging System

El O-arm reemplaza la necesidad de fluoroscopia y genera un conjunto de datos volumétricos en 3 dimensiones que se pueden ver como imágenes transversal, coronal y sagital de la columna, similar a la tomografía computarizada.

El conjunto de datos preoperatorios se pueden descargar en el sistema Stealth (Medtronic) o Brainlab permitiendo la navegación en tiempo real (Patil y col., 2012).

Una desventaja es el costo de la unidad de fluoroscopia O-arm, que cuenta actualmente con aproximadamente $ 700,000.00 y el sistema Treon StealthStation y un costo aproximado de $ 250,000.00 (Park y col., 2010).

Permite comprobar el resultado físico de la intervención antes de que el paciente salga del quirófano y durante la intervención, el sistema proporciona imágenes multidimensionales en 2D y volumétricas en 3D, así como imágenes fluoroscópicas.

De esta manera, el cirujano puede ver la anatomía del paciente en la posición operativa, supervisar el estado de la cirugía y verificar los cambios quirúrgicos con una imagen en 3D, lo que permite que el paciente se beneficie de una cirugía menos invasiva, se recupere más rápido, que la operación sea más corta y que se mejore el resultado final.

El dispositivo se mueve fácilmente y con mínimo esfuerzo gracias a su sistema de ruedas motorizadas y presenta un diseño especial. Cuenta con un pórtico que se abre y cierra alrededor del paciente, permite mantener el equipo estéril dentro del campo quirúrgico y es más seguro, ya que una vez cerrado el detector de imagen gira en el interior evitando que haya partes móviles que puedan golpear al paciente o a los profesionales. Además, permite memorizar posiciones de adquisición de imágenes ahorrando tiempo y minimizando la radiación para el paciente.

Se puede utilizar en intervenciones de columna vertebral y en cirugías craneales de patología cerebral y medular. El primero que se instaló en un hospital público español fué en el Hospital La Paz de Madrid.

Aumenta significativamente la precisión quirúrgica y la seguridad de la colocación del tornillo pedicular en la cirugía de fusión lumbar (Castro Castro y col., 2012).

Bibliografía

Castro Castro, Julián, Jon Rodino Padín, Alfonso Pinzón Millán, Jesús Patricio Agulleiro Díaz, Juan Manuel Villa Fernández, and Ana Pastor Zapata. 2012. “[Posterior Lumbar Fusion Using the O-arm Surgical Imaging System: Initial Experience.].” Neurocirugia (Asturias, Spain) (December 12). doi:10.1016/j.neucir.2012.09.006.

Bibliografía recomendada

1: Full rotation three-dimensional intraoperative imaging during spinal surgery (O-arm Imaging System). OR Manager. 2008 Dec;24(12):after p 16. PubMed PMID: 19119766.

2: Abul-Kasim K, Söderberg M, Selariu E, Gunnarsson M, Kherad M, Ohlin A. Optimization of Radiation Exposure and Image Quality of the Cone-beam O-arm Intraoperative Imaging System in Spinal Surgery. J Spinal Disord Tech. 2011 Mar 16. [Epub ahead of print] PubMed PMID: 21423057.

3: Ailawadhi P, Agrawal D, Satyarthee GD, Gupta D, Sinha S, Mahapatra AK. Use of O-arm for spinal surgery in academic institution in India: experience from JPN apex trauma centre. Neurol India. 2011 Jul-Aug;59(4):590-3. PubMed PMID: 21891939.

4: Birkhäuser FD, Zehnder P, Roth B, Schürch L, Ochsner K, Willener R, Thalmann GN, Burkhard FC, Studer UE. Irrigation of continent catheterizable ileal pouches: tap water can replace sterile solutions because it is safe, easy, and economical. Eur Urol. 2011 Apr;59(4):518-23. Epub 2011 Jan 12. PubMed PMID: 21256669.

5: Bohnstedt BN, Tubbs RS, Cohen-Gadol AA. The Use of Intraoperative Navigation for Percutaneous Procedures at the Skull Base Including a Difficult-to-Access Foramen Ovale. Neurosurgery. 2011 Aug 3. [Epub ahead of print] PubMed PMID: 21822157.

6: Britten CD, Gomes AS, Wainberg ZA, Elashoff D, Amado R, Xin Y, Busuttil RW, Slamon DJ, Finn RS. Transarterial chemoembolization plus or minus intravenous bevacizumab in the treatment of hepatocellular cancer: A pilot study. BMC Cancer. 2012 Jan 14;12(1):16. [Epub ahead of print] PubMed PMID: 22244160.

7: Caire F, Gantois C, Torny F, Ranoux D, Maubon A, Moreau JJ. Intraoperative use of the Medtronic O-arm for deep brain stimulation procedures. Stereotact Funct Neurosurg. 2010;88(2):109-14. Epub 2010 Feb 5. PubMed PMID: 20134210.

8: Costa F, Tomei M, Sassi M, Cardia A, Ortolina A, Servello D, Fornari M. Evaluation of the rate of decompression in anterior cervical corpectomy using an intra-operative computerized tomography scan (O-Arm system). Eur Spine J. 2012 Feb;21(2):359-63. Epub 2011 Sep 24. PubMed PMID: 21947870.

9: Garrido BJ, Wood KE. Navigated placement of iliac bolts: description of a new technique. Spine J. 2011 Apr;11(4):331-5. PubMed PMID: 21474085.

10: Houten JK, Nasser R, Baxi N. Clinical Assessment of Percutaneous Lumbar Pedicle Screw Placement Using the O-arm Multidimensional Surgical Imaging System. Neurosurgery. 2011 Sep 23. [Epub ahead of print] PubMed PMID: 21946509.

11: Ishikawa Y, Kanemura T, Yoshida G, Matsumoto A, Ito Z, Tauchi R, Muramoto A, Ohno S, Nishimura Y. Intraoperative, full-rotation, three-dimensional image (O-arm)-based navigation system for cervical pedicle screw insertion. J Neurosurg Spine. 2011 Nov;15(5):472-8. Epub 2011 Jul 15. PubMed PMID: 21761967.

12: Kim JS, Eun SS, Prada N, Choi G, Lee SH. Modified transcorporeal anterior cervical microforaminotomy assisted by O-arm-based navigation: a technical case report. Eur Spine J. 2011 Jul;20 Suppl 2:S147-52. Epub 2010 May 21. PubMed PMID: 20490870; PubMed Central PMCID: PMC3111514.

13: Kim S, Chung J, Yi BJ, Kim YS. An assistive image-guided surgical robot system using O-arm fluoroscopy for pedicle screw insertion: preliminary and cadaveric study. Neurosurgery. 2010 Dec;67(6):1757-67; discussion 1767. PubMed PMID: 21107207.

14: Koivukangas T, Katisko JP, Koivukangas JP. Technical accuracy of an O-arm registered surgical navigator. Conf Proc IEEE Eng Med Biol Soc. 2011 Aug;2011:2148-51. PubMed PMID: 22254763.

15: Krishnakumar R. Comment on: use of O-arm for spinal surgery in academic institution in India: experience from JPN apex trauma centre. Neurol India. 2011 Sep-Oct;59(5):795-6; author reply 796. PubMed PMID: 22019689.

16: Larson AN, Santos ER, Polly DW Jr, Ledonio CG, Sembrano JN, Mielke CH, Guidera KJ. Pediatric pedicle screw placement using intraoperative computed tomography and 3-dimensional image-guided navigation. Spine (Phila Pa 1976). 2012 Feb 1;37(3):E188-94. PubMed PMID: 21738101.

17: Mardiak J, Bohunický L, Chovanec J, Sálek T, Koza I. Adjuvant clodronate therapy in patients with locally advanced breast cancer–long term results of a double blind randomized trial. Slovak Clodronate Collaborative Group. Neoplasma. 2000;47(3):177-80. PubMed PMID: 11043842.

18: Nottmeier EW, Young PM. Image-guided placement of occipitocervical instrumentation using a reference arc attached to the headholder. Neurosurgery. 2010 Mar;66(3 Suppl Operative):138-42. PubMed PMID: 20173564.

19: Nottmeier EW, Pirris SM, Balseiro S, Fenton D. Three-dimensional image-guided placement of S2 alar screws to adjunct or salvage lumbosacral fixation. Spine J. 2010 Jul;10(7):595-601. PubMed PMID: 20434406.

20: Oertel MF, Hobart J, Stein M, Schreiber V, Scharbrodt W. Clinical and methodological precision of spinal navigation assisted by 3D intraoperative O-arm radiographic imaging. J Neurosurg Spine. 2011 Apr;14(4):532-6. Epub 2011 Jan 28. PubMed PMID: 21275555.

21: Park MS, Lee KM, Lee B, Min E, Kim Y, Jeon S, Huh Y, Lee K. COMPARISON OF OPERATOR RADIATION EXPOSURE BETWEEN C-ARM AND O-ARM FLUOROSCOPY FOR ORTHOPAEDIC SURGERY. Radiat Prot Dosimetry. 2011 Apr 26. [Epub ahead of print] PubMed PMID: 21525041.

22: Park MS, Chung CY, Kwon DG, Huh Y, Lee K, Lee KM. The perspectives of users and developers in designing and developing O-arm imaging system. J Xray Sci Technol. 2011;19(2):199-204. PubMed PMID: 21606582.

23: Park P, Foley KT, Cowan JA, Marca FL. Minimally invasive pedicle screw fixation utilizing O-arm fluoroscopy with computer-assisted navigation: Feasibility, technique, and preliminary results. Surg Neurol Int. 2010 Aug 25;1:44. PubMed PMID: 20975974; PubMed Central PMCID: PMC2958329.

24: Patil S, Lindley EM, Burger EL, Yoshihara H, Patel VV. Pedicle Screw Placement With O-arm and Stealth Navigation. Orthopedics. 2012 Jan 16;35(1):e61-5. doi: 10.3928/01477447-20111122-15. PubMed PMID: 22229616.

25: Santos ER, Ledonio CG, Castro CA, Truong WH, Sembrano JN. The Accuracy of Intraoperative O-arm Images for the Assessment of Pedicle Screw Postion. Spine (Phila Pa 1976). 2012 Jan 15;37(2):E119-25. PubMed PMID: 21673628.

26: Santos ER, Ledonio CG, Castro CA, Truong WH, Sembrano JN. Validity of surgeon perception of navigated pedicle screw position: a cadaveric study. Spine (Phila Pa 1976). 2011 Jul 1;36(15):E1027-32. PubMed PMID: 21304435.

27: Schils F. O-arm® guided balloon kyphoplasty: prospective monocenter case series of 54 consecutive patients. Neurosurgery. 2011 Feb 26. [Epub ahead of print] PubMed PMID: 21368696.

28: Schils F. O-arm guided balloon kyphoplasty: preliminary experience of 16 consecutive patients. Acta Neurochir Suppl. 2011;109:175-8. PubMed PMID: 20960339.

29: Shahlaie K, Larson PS, Starr PA. Intraoperative computed tomography for deep brain stimulation surgery: technique and accuracy assessment. Neurosurgery. 2011 Mar;68(1 Suppl Operative):114-24; discussion 124. PubMed PMID: 21206322.

30: Silbermann J, Riese F, Allam Y, Reichert T, Koeppert H, Gutberlet M. Computer tomography assessment of pedicle screw placement in lumbar and sacral spine: comparison between free-hand and O-arm based navigation techniques. Eur Spine J. 2011 Jun;20(6):875-81. Epub 2011 Jan 21. PubMed PMID: 21253780; PubMed Central PMCID: PMC3099154.

31: Smith AP, Bakay RA. Frameless deep brain stimulation using intraoperative O-arm technology. Clinical article. J Neurosurg. 2011 Aug;115(2):301-9. Epub 2011 Apr 15. PubMed PMID: 21495822.

32: Sullivan JP, Warme BA, Wolf BR. Use of an O-arm intraoperative computed tomography scanner for closed reduction of posterior sternoclavicular dislocations. J Shoulder Elbow Surg. 2011 Oct 28. [Epub ahead of print] PubMed PMID: 22036535.

33: Zhang J, Weir V, Fajardo L, Lin J, Hsiung H, Ritenour ER. Dosimetric characterization of a cone-beam O-arm imaging system. J Xray Sci Technol. 2009;17(4):305-17. PubMed PMID: 19923687.

o-arm.txt · Última modificación: 2013/04/21 10:50 (editor externo)