First with new 3D technology

News

Karolinska University Hospital is the first in the world to use new, advanced three-dimensional navigation technology in spinal surgery. A team within neurosurgery, orthopaedics and neuroradiology has now carried out back operations using the new, advanced 3D navigation technology with successful results.

The technology enables better and safer insertion of spinal implants.

It has been developed under a cooperation agreement on innovative medical technology between Karolinska University Hospital and Philips. This ongoing collaboration aims to produce technical and medical innovations that provide the greatest benefit for patients.

"By working together in this way, we can influence the results, both on the basis of the needs we see in healthcare and in order to improve things for the patients. It is very exciting and an incredible opportunity to be able to help develop brand-new medical equipment for surgery with a focus on patient benefit," says Adrian Elmi Terander, senior registrar and medical doctor at the Neurosurgery department.

The new technology has now been used in operations on patients with conditions such as scoliosis and spondylolisthesis in order to correct the anatomy and alleviate pain.

"The aim of the operations is to improve the quality of life of the patients and this new technology makes procedures even safer."

Increases the level of precision

Surgical navigation systems in operations are nothing new – this is a technology that has been used for the past 20 years. With most of the systems currently being used, X-rays of the patient are usually taken before the operation. These images are then used as a basis for planning before and during the actual operation. With this new technology, X-rays are taken directly on the operating table and the three-dimensional X-ray image is combined with a high-resolution video image of the patient's anatomy in the operative field. For the care team, this provides greater opportunities to further increase the level of precision during operations.

The technology enables better and safer insertion of spinal implants.

"This new navigation technology gives us a high-resolution three-dimensional image of the patient's spine in the operating room. We combine this with the video image we see in the operative field. We can now plan the procedure virtually and can insert screws, for example, with great precision."

This improves both the care team's planning of the procedure and the surgeon's ability to guide the instruments during the operation. It also minimises the risk of the patient having to undergo another operation.

Check results immediately

"This is an important benefit. Being able to take three-dimensional images on the operating table means that we can now check the results immediately in the operating room without having to move the patient to a radiology department after the operation. It also means that we can make any necessary corrections right away."

The use of video images for navigation during the operation also reduces the overall radiation dose. The operation is performed with the minimum radiation dose for the patient, while the operating theatre staff are not exposed to any radiation at all.

Initially, this new navigation technique is being used for spinal surgery. It will then be further developed for use in cranial operations, trauma and other surgical disciplines. The procedures are currently being performed using open surgery, but the aim is also to be able to switch to using the navigation technology for minimally invasive surgery.

Text: Susanne Bergqvist

3D navigation

The new navigation technology enables a high-resolution three-dimensional image of the patient's spine (internal) to be produced in the operating room and this is then combined with the video image that can be seen in the operative field (external), which is then used for the virtual planning of the surgery. Following this plan enables screws, for example, to be inserted with great precision. The results are checked immediately in the operating room without having to move the patient to a radiology department.

Current study

The current study at Karolinska University Hospital is a collaboration between the Neurosurgery, Orthopaedic and Neuroradiology departments and Philips. Pre-studies for the clinical trials now being carried out show that this technology improves the overall accuracy of screw insertion from 64% to 85%. The results of the pre-study have been published in the scientific journal SPINE. The study is being carried out in multiple stages, the first of which relates to spinal surgery.

World first

Karolinska University Hospital is the first in the world to have performed operations using the new equipment. The technology will be installed in ten hospitals around the world.

The new technology has been developed under a cooperation agreement on innovative medical technology between Karolinska University Hospital and Philips. Continued cooperation will enable the system to be used for minimally invasive procedures and also further developed for use in other surgical disciplines, such as operations on the brain and associated blood vessels, as well as orthopaedics and trauma.