MySpine MC leaflet
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MYSPINE CASE MANAGEMENT • Patients are exposed to a low dose pre-op CT scan, resulting in a lower radiation exposure than a single full spine x-ray • Pre-operative planning potentially eliminates the need of intra-operative checks, with a dramatic reduction of irradiation -33% compared to the free-hand technique [11,13] MINIMALLY INVASIVE PATIENT-MATCHED SOLUTIONS • The cumulative dose is potentially reduced with respect to navigation-assisted technique MySpine is Safe for both OR Staff and Patients! CT BASED SEGMENTATION Effective radiation dose [mSv] 60 US, Annual dose limits for surgeons [b] 1. IMAGE ACQUISITION Low Dose CT scan to deliver 3D reconstruction of each patient’s vertebral anatomy 2. 3D PRE-OP PLAN MANAGEMENT The surgeon defines optimal implant parameters: screw diameter, length and trajectory 3. 3D PRINTING MYSPINE MC 3D patient-matched Jigs are sent to the hospital BEST HEALTHCARE NAVIGATION/ROBOTICS SOLUTION 4. MYSPINE MC MIS SURGERY Surgery with dedicated MySpine MC system O-Arm (Obese patient) [a] O-Arm (Slim patient) [c] Average annual US background radiation [e] Comparison of irradiation between conventional and competitors’ techniques and MySpine [a] Lange et.al. Estimating the effective radiation dose imparted to patients by intraoperative cone-beam computed tomography in toracolumbar spinal surgery, Spine 2013 [b] US Nuclear Regulatory Commission’s (USNRC) [c] Lange et.al. Estimating the effective radiation dose imparted to patients by intraoperative cone-beam computed tomography in toracolumbar spinal surgery, Spine 2013 [d] Biswas et.al. Radiation Exposure from Musculoskeletal Computerized Tomographic Scans, JBJS Am. 2009 [e] Health Physics Society Specialists in Radiation Safety, Lawrence Berkeley National Laboratory; Fact Sheet 2010 [f] Radiation Dose in X-Ray and CT Exams; 2013 Radiological Society of North America, Inc [g] MySpine, Charité University Hospital, Berlin, Germany REFERENCES ACCURATE PRE-OP PLANNING The MySpine Web Platform allows for a simple and accurate 3D pre-operative planning. The surgeon can simulate the final screw position in the patient’s medical images and preview any potential surgical critical aspects. Maximize screw length Adjust screw trajectory Optimize screw diameter Enhance cortical bone purchase Review critical anatomical aspects Set appropriate entry point 2D CT VIEW An effective tool for a personalized surgical planning. [1] Matsukawa K. et al., Incidence and Risk Factors of Adjacent Cranial Facet Joint Violation Following Pedicle Screw Insertion Using Cortical Bone Trajectory Technique, Spine, 2016 [2] Sakaura H. et al., Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study, JNS, 2016 [3] Khanna N. et al,. Spine (Phila Pa 1976). 2016 Apr;41 Suppl 8:S90-6. doi: 10.1097/BRS.0000000000001475. Medialized, Muscle-Splitting Approach for Posterior Lumbar Interbody Fusion: Technique and Multicenter Perioperative Results [4] Gautschi O. et al., Maximal access surgery for posterior lumbar inter body fusion (PLIF) with divergent, cortical bone trajectory (CBT) pedicle-screws: a good option for minimize spine access and maximize the field for nerve decompression, Journal of neurosurgical sciences, 2015 [5] Matsukawa -2nd MORE Japan MySpine cortical Bone Trajectory 2017. https://mysurgeon.medacta.com/uploads/presentation/attachments/d33a45ed-c550-438b-96b8-5e3fb1696725.mp4 [6] Matsukawa - Biomechanics of CBT (internal file) [7] Regev G etal., Nerve injury to the posterior rami medial branch during the insertion of pedicle screws: comparison of mini-open versus percutaneous pedicle screw insertion techniques. Spine. 20093411239-42 [8] Lamartina C. et al., Pedicle screw placement accuracy in thoracic and lumbar spinal surgery with a patient-matched targeting guide: a cadaveric study, European Spine Journal, 2015 [9] Santoni B.G. et al., Cortical bone trajectory for lumbar pedicle screws, The Spine Journal, 2009 [10] Mori K. et al., Short-Term Clinical Result of Cortical Bone Trajectory Technique for the Treatment of Degenerative Lumbar Spondylolisthesis with More than 1-Year Follow-Up, Asian Spine Journal, 2016 [11] Farshad M. et al., Accuracy of patient-specific template-guided vs. free-hand fluoroscopically controlled pedicle screw placement in the thoracic and lumbar spine: a randomized cadaveric study, European Spine Journal, 2017 [12] Chin K.R., Clinical Outcomes With Midline Cortical Bone Trajectory Pedicle Screws Versus Traditional Pedicle Screws in Moving Lumbar Fusions From Hospitals to Outpatient Surgery Centers, Clinical Spine Surgery, 2017 [13] Petrone S. et al., Cortical bone trajectory technique’s outcomes and procedures for posterior lumbar fusion: A retrospective study, Journal of Clinical Neuroscience, 2020 [14] Matsukawa K. et al., Accuracy of cortical bone trajectory screw placement using patient-specific template guide system, Neurosurgical Review, 2019 [15] Matsukawa K. et al., Cortical pedicle screw trajectory technique using 3D printed patient-specific-guide, M.O.R.E. Journal, 2018 [16] Marengo N. et al., Cortical Bone Trajectory Screw Placement Accuracy with a Patient-Matched 3-Dimensional Printed Guide in Lumbar Spinal Surgery: A Clinical Study, WORLD NEUROSURGERY, 2019 [17] Marengo N. et al., Cortical Bone Trajectory Screws in Posterior Lumbar Interbody Fusion: Minimally Invasive Surgery for Maximal Muscle Sparing—A Prospective Comparative Study with the Traditional Open Technique, Clinical Study, 2018 All trademarks are property of their respective owners and are registered at least in Switzerland. This document is not intended for the US market. Medacta International Strada Regina, 34 - 6874 Castel San Pietro - Switzerland Phone +41 91 696 60 60 - Fax + 41 91 696 60 66 Info@medacta.ch -www.medacta.com MySpine® MC Leaflet 99.my46MC.11 rev.01 Last update: March 2021 Surgical Technique Brochure Surgical Technique Joint