Navigation Techniques in Endoscopic Spine Surgery

Hagan, Matthew; Remacle, Thibault; Leary, Owen P.; Feler, Joshua; Shaaya, Elias; Ali, Rohaid; Zheng, Bryan; Bajaj, Ankush; Traupe, Erik; Kraus, M.; Zhou, Yue; Fridley, Jared; Lewandrowski, Kai‐Uwe; Telfeian, Albert E.

doi:10.1155/2022/8419739

Cited by 15 publications

(9 citation statements)

References 79 publications

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“…Robotic surgery has improved accuracy in total joint replacement component placement [ 71 , 72 , 73 ]. Navigation is another add-on technology with similar goals of improving patient outcomes by reducing inaccuracies in the surgical approaches and techniques thought to be the source of higher complication and revision surgery rates [ 74 , 75 , 76 , 77 , 78 ]. Depending on the application, navigation and augmented reality (AR) may be utilized separately or together [ 79 , 80 , 81 , 82 ].…”

Section: Impact Of Transformative Technologies and Targeted Care Modelsmentioning

confidence: 99%

The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

Lewandrowski

Elfar

et al. 2023

JPM

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Personalized care models are dominating modern medicine. These models are rooted in teaching future physicians the skill set to keep up with innovation. In orthopedic surgery and neurosurgery, education is increasingly influenced by augmented reality, simulation, navigation, robotics, and in some cases, artificial intelligence. The postpandemic learning environment has also changed, emphasizing online learning and skill- and competency-based teaching models incorporating clinical and bench-top research. Attempts to improve work–life balance and minimize physician burnout have led to work-hour restrictions in postgraduate training programs. These restrictions have made it particularly challenging for orthopedic and neurosurgery residents to acquire the knowledge and skill set to meet the requirements for certification. The fast-paced flow of information and the rapid implementation of innovation require higher efficiencies in the modern postgraduate training environment. However, what is taught typically lags several years behind. Examples include minimally invasive tissue-sparing techniques through tubular small-bladed retractor systems, robotic and navigation, endoscopic, patient-specific implants made possible by advances in imaging technology and 3D printing, and regenerative strategies. Currently, the traditional roles of mentee and mentor are being redefined. The future orthopedic surgeons and neurosurgeons involved in personalized surgical pain management will need to be versed in several disciplines ranging from bioengineering, basic research, computer, social and health sciences, clinical study, trial design, public health policy development, and economic accountability. Solutions to the fast-paced innovation cycle in orthopedic surgery and neurosurgery include adaptive learning skills to seize opportunities for innovation with execution and implementation by facilitating translational research and clinical program development across traditional boundaries between clinical and nonclinical specialties. Preparing the future generation of surgeons to have the aptitude to keep up with the rapid technological advances is challenging for postgraduate residency programs and accreditation agencies. However, implementing clinical protocol change when the entrepreneur–investigator surgeon substantiates it with high-grade clinical evidence is at the heart of personalized surgical pain management.

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Section: Impact Of Transformative Technologies and Targeted Care Modelsmentioning

confidence: 99%

The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

Lewandrowski

Elfar

et al. 2023

JPM

Self Cite

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“…A relatively new concept in anesthesiology, Enhanced Recovery After Surgery (ERAS) Protocols first emerged in the 1990s for colonic and rectal resections [45]. Some of the earliest studies of ERAS protocols for craniotomy and spinal fusion would come out in the early 2000s and slowly evidence has been built for the dramatic outcomes that ERAS protocols can provide [46].…”

Section: Enhanced Recovery After Surgery Protocols In Neurosurgerymentioning

confidence: 99%

“…A 2019 randomized control trial by Yang et craniotomy for aneurysm repair compared effects of scalp block with injection of ropivacaine versus standard IV analgesia [47]. They found reductions in postoperative scalp inflammation, blood loss during scalp incision, and better control of postoperative pain as compared to a control group [45]. Minimally invasive techniques for neurosurgical diseases are few and far between, but some patients can be treated through keyhole incisions for some cysts and tumors.…”

Section: Enhanced Recovery After Surgery Protocols In Neurosurgerymentioning

confidence: 99%

Updates in Neuroanesthesia

Schill¹,

Bates²,

Lovett³

et al. 2023

Updates in Anesthesia - The Operating Room and Beyond

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Providing anesthesia care to neurosurgical and neurocritical care patients presents unique challenges to the anesthesiologist. Over the last century, anesthetic care for such patients has become a robustly studied field, with tools and techniques to keep patients safe and comfortable in the perioperative period. A review of the major updates and considerations for perioperative care for awake craniotomies, thrombectomy for stroke, and endoscopic neurosurgery is critical for the anesthesiologist. Additionally, newly developed enhanced recovery after surgery procedures have improved patient experiences and outcomes after both cranial and spinal neurosurgery. Finally, post-operative delirium is a major neurologic complication in elderly patients undergoing all types of procedures which all anesthesiologists should be well versed in. Here, such topics are reviewed with a focus on recent updates to the literature which are important for clinical practice.

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“…Electromagnetic tracking (EMT) is the only tracking technology to date that can determine the position of multiple sensors in the absence of a line-ofsight and with sub-millimeter accuracy. 1,2 For these reasons, EMT is the method of choice for guiding bronchoscopies, biopsies and ablations, [3][4][5][6][7][8][9][10] endoscopic and minimally-invasive surgery, [11][12][13] and in computerassisted interventions. [14][15][16] Recently, EMT systems have attracted increasing interest in the context of brachytherapy (BT).…”

Section: Introductionmentioning

confidence: 99%

A comprehensive quality assurance protocol for electromagnetic tracking in brachytherapy

Dürrbeck,

Gomez‐Sarmiento,

Androulakis

et al. 2024

Medical Physics

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BackgroundElectromagnetic tracking (EMT) systems have proven to be a valuable source of information regarding the location and geometry of applicators in patients undergoing brachytherapy (BT). As an important element of an enhanced and individualized pre‐treatment verification, EMT can play a pivotal role in detecting treatment errors and uncertainties to increase patient safety.PurposeThe purpose of this study is two‐fold: to design, develop and test a dedicated measurement protocol for the use of EMT‐enabled afterloaders in BT and to collect and compare the data acquired from three different radiation oncology centers in different clinical environments.MethodsA novel quality assurance (QA) phantom composed of a scaffold with supports to fix the field generator, different BT applicators, and reference sensors (sensor verification tools) was used to assess the precision (jitter error) and accuracy (relative distance errors and target registration error) of the EMT sensor integrated into an afterloader prototype. Measurements were repeated in different environments where EMT measurements are likely to be performed, namely an electromagnetically clean laboratory, a BT suite, an operating room, and, if available, a CT suite and an MRI suite dedicated to BT.ResultsThe mean positional jitter was consistently under 0.1 mm across all measurement points, with a slight trend of increased jitter at greater distances from the field generator. The mean variability of sensor positioning in the tested tandem and ring gynecological applicator was also below 0.1 mm. The tracking accuracy close to the center of the measurement volume was higher than at its edges. The relative distance error at the center was 0.2‐0.3 mm with maximum values reaching 1.2‐1.8 mm, but up to 5.5 mm for measurement points close to the edges. In general, similar accuracy results were obtained in the clinical environments and in all investigated institutions (median distance error 0.1‐0.4 mm, maximum error 1.0‐2.0 mm), however, errors were found to be larger in the CT suite (median distance error up to 1.0 mm, maximum error up to 3.6 mm).ConclusionThe presented quality assessment protocol for EMT systems in BT has demonstrated that EMT offers a high‐accuracy determination of the applicator/implant geometry even in clinical environments. In addition to that, it has provided valuable insights into the performance of EMT‐enabled afterloaders across different radiation oncology centers.

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Navigation Techniques in Endoscopic Spine Surgery

Cited by 15 publications

References 79 publications

The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

The Changing Environment in Postgraduate Education in Orthopedic Surgery and Neurosurgery and Its Impact on Technology-Driven Targeted Interventional and Surgical Pain Management: Perspectives from Europe, Latin America, Asia, and The United States

Updates in Neuroanesthesia

A comprehensive quality assurance protocol for electromagnetic tracking in brachytherapy

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