Abstract
Background When using mobile 3D C-arms, impairments in image quality occur due to artefacts
caused by metal implants as well as to the limited field of view. To avoid these
restrictions, special computed tomography devices were designed, in order to
improve image quality and to meet requirements for intraoperative usage.
Objectives To analyse practicability and benefits of a mobile intraoperative CT device (Airo,
Brainlab, Munich, Germany) on the basis of several parameters that were obtained during
a 40-month period.
Materials and Methods All procedures that were performed with usage of intraoperative CT between January
2017 and April 2020 were analysed with respect to anatomical region, count of
scans, duration of scans, consequences drawn from the scans and use of navigation.
Results 354 CT-scans were performed in 171 patients (mean 2.07 [1 – 6] scans per procedure).
47.81% of the procedures were spinal, 52.19% affected the pelvis. 83% of the procedures
were navigated. In 22% of patients, improvement in implant placement or reduction
was achieved; in most patients (55%), a guidewire for pedicle screws was corrected.
The mean scan duration
was 10.33 s (3.54 – 21.72).
Conclusions Use of intraoperative CT was reliable and helpful. Integration in OR standards requires
more effort than mobile 3D C-arms. Image quality was outstanding for
intraoperative conditions and allowed proper assessment of implant placement
and reduction in all cases. Due to the high financial outlay of the system and the
good image quality of 3D
C-arms in the extremities, we assume that this procedure can be applied in intraoperative
CT in traumatological cases in spinal and pelvic surgery in high-level trauma centres.
Key words
intraoperative imaging - intraoperative computed tomography - 3D imaging - spine trauma
- pelvic trauma
