Marshal D. Peris, MD Chief of Spine Surgery, Northern Westchester - PowerPoint PPT Presentation

Marshal D. Peris, MD Chief of Spine Surgery, Northern Westchester Hospital Caremount Medical Department of Orthopedic Surgery Mount Kisco, NY

 Reduce Surgeon Radiation Exposure/NO LEAD  Improve Accuracy of Hardware Placement  Reduce Return to OR for Hardware Misplacement  Reduced Workflow Interruption  Make Deformity Surgery Easier and Safer  Make Minimally Invasive Surgery Easier and Faster ◦ Reduced blood loss and OR time ◦ Reduced length of stay ◦ No Guidewires

 Posterior Cervical Fusions  Posterior Lumbar Fusions  Lateral Lumbar Fusions  SI joint Fusions  Thoracic Fusions  Iliac Screw Placement

 At Northern Westchester Hospital we use the Medtronic O-arm and Stealth Navigation  2 ways to use the technology 1. Confirm the hardware you placed in standard fashion is in good position before leaving the OR.  We do this on every Posterior Cervical and Lumbar Fusion reducing our return to OR to ~0% for hardware misplacement

2. Navigate your hardware and implants without the use of C arm/Xray  “Spin” the O arm early in the procedure to create navigation images using a navigation array attached to a spinous process or in the PSIS  View multiple orientations simultaneously (Sagital/Axial)  Instruments all integrated with the navigation system  Premeasure screw length and diameter  Interbody and/or Screws placed using navigation and then checked with neuromonitoring stimulation and a final “spin”  Don’t allow the soft tissues to push you out of ideal position

Technique Pics

Technique Pics

Technique Pics

Technique Pics

Check your Results

Check Your Results

Posterior Cervicothoracic Fusion

Posterior Cervicothoracic Fusion

Check Your Results

Leave the OR Happy and Relaxed