Percutaneous laser discectomy guided with stereotactic computer-assisted surgical navigation

Lasers in Surgery and Medicine
Ronald A von Jako, Zsolt Cselik

Abstract

Percutaneous laser discectomy at various wavelengths has been used for minimally invasive surgery of herniated intervertebral discs. Using a high-intensity diode laser at 980-nm wavelength, we aimed to improve the safe insertion of the laser trocar with the aid of a stereotactic computer-assisted surgical navigation system. The experiments were performed on ex vivo porcine spines with intact soft tissue. Before laser irradiation, each specimen was imaged by computed tomography (CT) with fiduciary markers. The Digital Imaging and Communications in Medicine (DICOM standard) data sets were retrieved into the GE Healthcare Surgery InstaTRAK3500 Plus computer-assisted surgical navigation platform via the hospital Ethernet using a picture archiving and communication system. A special trocar with quartz waveguide connected to the navigation system was inserted into a total of 12 lumbar discs of two fresh intact porcine specimens. Various laser energies (200-700 J) with different exposure times were delivered. Pre- and post-irradiation magnetic resonance (MR) imaging and postoperative macroscopic and histologic studies were carried out. A navigation system accuracy of better than 2 mm was achieved. Tracking of the instrument from pre-a...Continue Reading

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Citations

Sep 14, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jörg A K OhnsorgeMarkus Weisskopf
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