Straightening Out Scoliosis with the Medtronic O-ARM® System

One young woman in particular, Charlotte Holl, suffered from scoliosis well into her teenage years. Her options were few: surgery – to permanently fuse her spine straight – or no surgery, which carries the risk of the spinal deformity progressing, and possibly affecting her internal organs. Charlotte’s spine had developed a 50-degree curve, which, left untreated, was likely to increase. In some cases where the curvature exceeds 70 degrees, the severe twisting of the spine can press the ribs against the lungs and eventually affect the heart. Studies also show that adults with scoliosis are prone to chronic and higher incidence of back pain compared with the general population. Facing these probable outcomes, and following two years of evaluation, Charlotte and her parents elected to move forward with the operation.

In addition to the already steep risks associated with a prolonged spinal surgery, doctors faced the challenge of drilling 12 screws into the narrow wings of bone on Charlotte’s vertebrae, while simultaneously avoiding surrounding tissue and organs – including her spinal cord, aorta, and lungs. One mistake near the spinal cord could lead to a lifetime of paralysis, so doctors knew they needed to employ the best imaging technology available to ensure success.

For this vastly complex surgery, University of California at San Francisco (UCSF) surgeons chose the Medtronic O-ARM® System. Its high-resolution intra-operative images provide surgeons a 3D view of the patient in the operative position, which allows them to view anatomy and confirm hardware placement in the axial, coronal, and sagittal views prior to closing the patient. In many cases, this eliminates the need for post-operative scans and often leads to shorter recovery times for patients like Charlotte.

According to Dr. Shane Burch, Orthopedic Surgeon at UCSF, “The O-ARM® System allows us to have a real 3D visualization of where we’re putting the instrumentation. It just allows us to be precise.”

In surgery, doctors positioned Charlotte face down in order to expose the vertebrae and place screws. The screws would anchor steel rods designed to permanently straighten Charlotte’s spine – ceasing the deformity progress and improving her quality of life.

Surgeons relied on the O-ARM® System as their guide when placing the screws. Using reflective spheres as markers on drills and other instruments, the O-ARM® System works in tandem with the Medtronic StealthStation® System to generate images that show doctors exactly where the instruments extend inside Charlotte’s body. This millimeter-accurate system enabled surgeons at UCSF to insert pedicle screws precisely in the vertebrae, ultimately leading to the successful straightening of Charlotte’s spine and protection of her surrounding organs and tissue during the procedure.

Following surgery, Charlotte instantly gained two inches in height, and she can now stand up straight. She was back in school within a month of surgery, and doctors expect her to be able to return to normal sports activities within a year.

“Just feels so good, you know,” Charlotte says with a smile, “walking around with a long, lean torso and a straight back – for once!”

Tomorrow’s Intra-operative Imaging Technology… Today

The Medtronic O-ARM® System has captured the imagination of the surgical community who, for the first time, is able to acquire 3D volumetric imaging with the convenience of a C-arm but with CT-like image quality. Because the O-ARM® System is a mobile platform, it does not require a dedicated room and can be used during multiple surgeries across different specialties.

In addition to the O-ARM® System, Medtronic offers the PoleStar® iMRI Navigation Suite – the only intra-operative MR image-guidance system designed for an existing operating room.

Utilization of MRI in the OR will continue to fuel growth in the intra-operative MRI market, which will add to Medtronic’s market-leading position in the iMRI space – especially when cost-benefit analysis and realistic assessments of OR workflow are taken into purchase consideration.

While the field of Diagnostic Imaging is quite crowded with world-class companies, we believe Medtronic stands out as the intra-operative imaging company committed to every facet of surgery and emerges uniquely positioned to provide clinical solutions to our surgeon and radiology customers.

Whether surgeons are using intra-operative imaging to remove a brain tumor or correct a spinal deformity, they can close with confidence. They can confirm the extent of the tumor removal or hardware placement before closing the patient – rather than waiting for a post-op scan. For patients, this may mean shorter recovery time and a decreased need for repeat surgeries.

Medtronic is the world leader in medical technology providing lifelong solutions for people with chronic disease. We offer products, therapies and services that enhance or extend the lives of millions of people. Each year, 6 million patients benefit from Medtronic's technology, used to treat conditions such as diabetes, heart disease, neurological disorders, and vascular illnesses. The Medtronic Mission drives us to continuously explore opportunities to further alleviate pain, restore health and extend life for people with chronic diseases. Working with healthcare providers, we focus on three key goals: advancing patient care through innovation, increasing awareness and patient access, and improving outcomes to ensure quality care.

Portions of this article were derived from video created by KTVU news, San Francisco.