Technical Note| Volume 16, ISSUE 12, P1624-1627, December 2009

Download started.


Use of isocentric fluoroscopy during transoral odontoidectomy


      The intra-operative isocentric C-arm (Siremobil Iso-C 3D; Siemens Medical Solutions, Erlangen, Germany) allows for the acquisition and immediate interpretation of multiplanar three-dimensional images. The utility of isocentric fluoroscopy in surgery of the spine has been well described, in patients with percutaneous kyphoplasty, anterior cervical discectomy and fusion, fracture repair, as well as in percutaneous instrumentation at cervical, thoracic and lumbar levels. Two patients who underwent transoral odontoidectomy are presented in whom isocentric fluoroscopy was utilized to provide an intra-operative CT scan. Use of this technology allowed the surgeon to detect residual bone peri-operatively, thus allowing for a more extensive decompression and excellent clinical results. Intra-operative isocentric fluoroscopy in transoral odontoidectomy allows for peri-operative detection of residual bone fragments and intra-operative confirmation of complete decompression.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Clinical Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Hott J.S.
        • Deshmukh V.R.
        • Klopfenstein J.D.
        • et al.
        Intraoperative Iso-C C-arm navigation in craniospinal surgery: the first 60 cases.
        Neurosurgery. 2004; 54: 1131-1136
        • Villavicencio A.T.
        • Burneikiene S.
        • Bulsara K.R.
        • et al.
        Intraoperative three-dimensional fluoroscopy-based computerized tomography guidance for percutaneous kyphoplasty.
        Neurosurg Focus. 2005; 18: 3
        • Villavicencio A.T.
        • Burneikiene S.
        • Bulsara K.R.
        • et al.
        Utility of computerized isocentric fluoroscopy for minimally invasive spinal surgical techniques.
        J Spinal Disord Tech. 2005; 18: 369-375
        • Holly L.T.
        • Foley K.T.
        Percutaneous placement of posterior cervical screws using three-dimensional fluoroscopy.
        Spine. 2006; 31: 536-540
        • Holly L.T.
        • Foley K.T.
        Three-dimensional fluoroscopy-guided percutaneous thoracolumbar pedicle screw placement.
        J Neurosurg. 2004; 99: 324-329
        • Rajasekaran S.
        • Vidyadhara S.
        • Ramesh P.
        • et al.
        Randomized clinical study to compare the accuracy of navigated and non-navigated thoracic pedicle screws in deformity correction surgeries.
        Spine. 2007; 32: E56-E64
        • Wang M.Y.
        • Kim K.A.
        • Liu C.Y.
        • et al.
        Reliability of three-dimensional fluoroscopy for detecting pedicle screw violations in the thoracic and lumbar spine.
        Neurosurgery. 2004; 54: 1138-1142
        • Baldauf J.
        • Muller J.U.
        • Fleck S.
        • et al.
        The value of intraoperative three dimensional fluoroscopy in anterior decompressive surgery of the cervical spine.
        Zentralbl Neurochir. 2008; 69: 30-34
        • Rajasekaran S.
        • Kamath V.
        • Shetty A.P.
        Intraoperative Iso-C three-dimensional navigation in excision of spinal osteoid osteomas.
        Spine. 2008; 33: E25-E29
        • Rajasekaran S.
        • Vidyadhara S.
        • Shetty A.P.
        Iso-C3D fluoroscopy-based navigation in direct pedicle screw fixation of Hangman fracture: a case report.
        J Spinal Disord Tech. 2007; 20: 616-619
        • Gebhard F.T.
        • Kraus M.D.
        • Schneider E.
        • et al.
        Does computer-assisted spine surgery reduce intraoperative radiation doses?.
        Spine. 2006; 31: 2024-2027