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Die Wirbelsäule 2017; 01(04): 317-334
DOI: 10.1055/s-0043-112422
CME-Fortbildung
© Georg Thieme Verlag KG Stuttgart · New York

Stellenwert der Navigation

Jan-Sven Jarvers
,
Ulrich Spiegl
,
Stefan Glasmacher
,
Christoph E. Heyde
,
Christoph Josten
Subject Editor: Wissenschaftlich verantwortlich gemäß Zertifizierungsbestimmungen für diesen Beitrag ist Dr. med. Jan-Sven Jarvers, Leipzig.
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Publication History

Publication Date:
07 November 2017 (online)

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Abstract

Importance of Navigation Navigation and intraoperative imaging have undergone an enormous development in recent years. By using intraoperative navigation, the precision of pedicle screw implantation can be increased in the sense of patient safety. Especially in the case of complex defects or tumor diseases, navigation is a decisive aid. As a result of the constantly improved technology, the requirements for reduced radiation exposure and intraoperative control can also be met. The high costs of the devices can be amortized, for example by a reduced number of revisions. This overview presents the principles of navigation in spinal surgery and the advantages and disadvantages of the different navigation procedures.

In dieser Übersichtsarbeit werden die Prinzipien der Navigation in der Wirbelsäulenchirurgie und deren Stellenwert mit den Vor- und Nachteilen der verschiedenen Navigationsverfahren dargestellt. Durch die Anwendung der intraoperativen Navigation kann die Präzision der Pedikelschraubenimplantation und damit die Patientensicherheit erhöht werden. Auch bei komplexen Fehlstellungen oder Tumorerkrankungen leistet die Navigation eine entscheidende Hilfe.
Fazit

  • Die Präzision von Pedikelschrauben kann durch die Navigation verbessert werden.

  • Nach einer anfänglichen Lernkurve kann die Operationszeit vermindert werden.

  • Durch Navigation kann vor allem beim Personal eine Strahlenreduktion erreicht werden.

  • Den hohen Kosten der Anschaffung müssen die erhöhte Sicherheit und die Reduktion von Revisionsoperationen entgegengehalten werden.

  • Die intraoperative Schraubenkontrolle in allen Ebenen ist der große Vorteil der Verfahren

    • iCT ( = intraoperativ angefertigte Computertomografie),

    • 3D-C-Arm,

    • Flachdetektor-gestützte Verfahren.

  • Gerade bei komplexen Eingriffen kann die Navigation hilfreich sein.

  • Die Navigation stellt mitnichten eine Absicherung des Unerfahrenen dar, sondern ist ein fortgeschrittenes Modul in der Hand des Erfahrenen.

  • Der Operateur muss jederzeit in der Lage sein, die Operation auch ohne diese technischen Hilfsmittel zu Ende zu bringen.

Schlüsselwörter

Wirbelsäulenchirurgie - intraoperative Bildgebung - 3D-C-Bogen - Flachdetektor - Pedikelschrauben - intraoperatives CT

Keywords

spine surgery - intraoperative imaging - 3 D C-arm - flatpanel - pedicle screws - intraoperative CT
 

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