Clinical Applications in Spine Surgery
The complex three-dimensional anatomy and pathology of the spine offers an excellent opportunity to capitalize on the advantages of holographic imaging. These advantages include (1) a three-dimensional image display that may be viewed from a variety of angles, (2) a precise quantitative reproduction of the object being imaged, (3) a translucent image that allows the viewer to visualize both the deep and superficial structures simultaneously, (4) an image display with which the viewer may interact to plan and practice surgical maneuvers, (5) an image display that may be oriented in accordance with the surgeon's view, and (6) a portable image displayer that is convenient to use intraoperatively to display large volumes of presurgical data (CT and MRI).
The application of holography in specific spinal disorders best demonstrates the clinical utility of this modality. For example, the formulation and execution of the optimal operative strategy in the stabilization of a complex spinal fracture requires a sound understanding of the spatial relationships between the osseous, ligamentous, and neural elements. Each step of the procedure, including the decompression, the fusion, and the instrumentation, might be facilitated by the use of holography (Fig. 6).
Case presentation. A patient with a severe lateral lumbar spine translational deformity. AP and lateral radiographs of the lumbar spine (a and b); CT of lumbar spine (c); VMETH of the anatomic region of interest (d). Note the clear definition of the bony pathology when viewing the spine from different orientations.
Case presentation. A patient with a severe lateral lumbar spine translational deformity. AP and lateral radiographs of the lumbar spine (a and b); CT of lumbar spine (c); VMETH of the anatomic region of interest (d). Note the clear definition of the bony pathology when viewing the spine from different orientations.
Case presentation. A patient with a severe lateral lumbar spine translational deformity. AP and lateral radiographs of the lumbar spine (a and b); CT of lumbar spine (c); VMETH of the anatomic region of interest (d). Note the clear definition of the bony pathology when viewing the spine from different orientations.
Case presentation. A patient with a severe lateral lumbar spine translational deformity. AP and lateral radiographs of the lumbar spine (a and b); CT of lumbar spine (c); VMETH of the anatomic region of interest (d). Note the clear definition of the bony pathology when viewing the spine from different orientations.
A clinical example illustrating the benefits of holography is its application in pedicle screw instrumentation. The advantage of holography over fluoroscopic guidance as a radiologic aid in this setting has been shown in a prospective study.[1] Pedicle screw instrumentation requires a clear understanding of the spatial relationships between the facet joints, the transverse processes, the pedicles, the vertebral bodies, and the neural elements, in order to determine a safe and accurate insertion site, trajectory, and target. To facilitate these goals, holography offers the advantages of visualization of the deep (ie, pedicle and vertebral body) and superficial structures (ie, facet joint, transverse process, and lamina) simultaneously; a three-dimensional representation of important topographical relationships; and the ability to view the image from a variety of different angles, including the critical surgical view. Similar advantages may facilitate the planning and proper execution of a variety of other spinal operations.
Medscape Orthopaedics & Sports Medicine eJourn. 1998;2(2) © 1998 Medscape
Cite this: Holographic Imaging in Spine Surgery: Overview and Clinical Applications - Medscape - Apr 27, 1998.
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