How a Hybrid OR can improve minimally invasive spine surgery

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As physicians perform more minimally invasive spine surgery procedures, many are working in a Hybrid Operating Room (OR). The Orthopedic and Emergency Surgery team at the University Medical Center Schleswig-Holstein (UKSH) explains the benefits they have experienced over the past three years of performing minimally invasive spine surgery in Philips Hybrid OR.

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One of Europe’s largest centers for medical care

The UKSH is one of Europe’s largest centers for medical care with locations in Kiel and Lübeck. It is one of the few places in Germany where top international physicians, scientists and researchers come together to treat patients, carry out research and teach. Each year the orthopedic team handles about 3,000 inpatient cases and performs around 4,000 operations, including 200 spinal procedures.

Prof. Dr. A. Seekamp MD, Director of the Orthopedic and Emergency Surgery clinic has seen a clear transition to minimally invasive procedures for surgically treating fractures and instabilities of the spinal column. “Almost half of our interventions for simple spinal fractures, for example, have now gone to minimally invasive procedures.”

I had expected the operations to take a little longer in the Hybrid OR, but they are, in fact, shorter.”

Prof. Dr. A. Seekamp MD,

Director of the Orthopedic and Emergency Surgery clinic, University Medical Center Schleswig-Holstein, Kiel, Germany

High quality 2D and 3D spine surgery imaging

In the UKSH Hybrid OR, Philips Allura X-ray system with a large-area Flat Detector provides exceptional 2D and 3D visualizations of complex spinal structures – providing far higher image quality than an image intensifier system – to enhance confidence, decision making and precision during spinal surgery.

Prof. Dr. A. Seekamp says, ““What’s also special about the X-ray unit in the Hybrid OR is the fact that we have orthograde parallel imaging showing up multiple disc levels, including disc spaces. They are imaged orthograde, meaning in both the lateral and the AP position, so we really only need one setting and can treat practically the entire surgical area. That’s a huge advantage compared to the conventional image intensifier system, which has to be set up for each individual lateral and AP projection.”

Shorter procedures without CT
Sending patients for a post-operative CT scan to check the implant position used to be standard procedure for spinal surgery says Prof. Dr. Seekamp. That has changed with the intra-operative cone beam CT (XperCT) imaging provided by the Allura system. “Post-operative CT scans to check implant placements are no longer necessary; it is possible to verify whether a procedure has been successful immediately after treatment. As soon as surgery has been performed, we can be 100% sure that implants are in place, thanks to the high quality of the intra-operative cone beam CT (XperCT) image and positioning flexibility of the system.”

Saving time on spine surgery imaging

“Being able to store and recall positions is an important advantage,” says Prof. Dr. A. Seekamp. “Once a patient has been positioned, we can precisely mark pedicle screw entry points and especially the level of injury and store these positions. You press a button and immediately see both the AP and lateral adjustment which saves a huge amount of time.”