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"Measure twice, cut once.” It’s a simple expression that reminds us to be precise, and it applies in many situations—even complicated neurosurgical procedures.
Traditional imaging systems made adhering to this old adage a challenge for neurosurgeons. Large, stationary computed tomography (CT) scanners offer limited usefulness during surgery that made surgeries take longer and sometimes led to the need for multiple procedures.
Enter the Airo Mobile Intraoperative CT system—a portable, high-definition imaging system that has redefined our neurosurgical processes. We are the first hospital in Washington, D.C., to use this revolutionary system, and we now can offer faster, more precise neurosurgery with better outcomes and less radiation exposure than ever before. Having this advanced technology has allowed us to care for patients when other hospitals couldn’t.
Mobility matters in CT scanning
The huge, stationary scanning machines of old limited us to either scanning patients before their procedures or transporting them from the operating room to the imaging lab mid-surgery, then back to the operating room.
With the Airo scanner, we bring the scanner to the patient instead of the other way around, and just one person can move it. We can create accurate CT images of the brain or spine right up to the time surgery begins and also can scan in real time during the surgery to guide us more effectively during complex procedures, which often leads to quicker, more precise surgeries.
Having the CT scanner in the operating room also lets us instantly learn whether a procedure is successful. With the old scanners, because of infection-control procedures, we had to wait until the patient was out of surgery and recovering the following day before we could do a follow-up scan. The old scanners were not surgically sterile, which caused delays in scanning.
If we found anything wrong during follow-up, we then would have to take the patient back into surgery. Now, we can scan the patient immediately after the surgery, while they are still asleep, to make sure we have a successful outcome or make any revisions during the same procedure. This technology already is resulting in more patients seeking neurosurgery at MedStar Washington Hospital Center.
The Airo mobile CT scanning system’s real-time, highly accurate #CTscans during complex #neurosurgery leads to faster procedures and better patient outcomes. https://bit.ly/2AsmJ13 via @MedStarWHC
Patient success story
Among the most outstanding examples is a patient who had gone to several centers looking for the right team for his spine surgery. He chose us because we had the Airo scanner, and the device was extremely helpful for his procedure. This patient’s surgery involved the use of pedicle screws, which are inserted into small projections of bone called pedicles that join the front part of the spinal bones to the back part.
The patient’s pedicles were so small that it would have been a complicated process to get his screws into just the right position with our old scanning system. But the Airo system let me see where those screws needed to go in real time during the procedure, so I was able to get them in exactly the right place on the first approach. Just two and a half weeks after his surgery, the patient was walking without a walker or cane, and he and his wife were getting ready to go on a much-deserved vacation.
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Precise imaging for more accurate results
Tiny distances that are almost imperceptible to the eye are critical when it comes to neurosurgery. The Airo scanner creates images that are accurate down to less than a millimeter. Such precision is vital for delicate procedures such as pituitary surgery , and we are the only center in the country to my knowledge that that uses the Airo for that purpose.
While our old scanners gave us flat, two-dimensional images, the Airo scanner can integrate CT scans with magnetic resonance imaging (MRI) scans to create three-dimensional images. We overlap the MRI and CT scans on our imaging screens and mark the exact path of the procedure. This highly detailed system gives us a better look at tumors or other anomalies with up-to-the-second results.
Less radiation for improved patient safety
We take every precaution to limit our patients’ exposure to radiation, which can lead to a slightly increased risk of cancer with high, frequent doses.
The Airo CT scanner allows us to adjust the radiation dose a patient receives based on the area we have to scan. We can go from the full CT scan dose down to 20 to 30 percent of the standard dose, depending on what we need to see. That translates to much less radiation than we would typically have to use for the kind of scans we need for surgery.
Blazing new trails in neurosurgical imaging
We’re able to take advantage of this extraordinary imaging system because of our Center for Image-Guided Neuro-Integrative Surgery (CIGNIS) . Through CIGNIS, we partner with spine surgery device manufacturer K2M, which works closely with Brainlab, the Airo system’s manufacturer. Our hospital is an alpha site for the Airo CT scanner, meaning we train the companies’ customers, as well as U.S. and international neurosurgeons, on how to use the system in the operating room.
Neurosurgery, as well as medicine in general, is about not being satisfied with the status quo. We are all looking for breakthroughs that will allow us to treat patients who were once thought incurable and to improve care for everyone. The Airo Mobile Intraoperative CT system is one such advancement that takes our patient care to the next level.