gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Intraoperative three-dimensional imaging with the ISO-C3D in cervical spine surgery

Intraoperative 3D-Bildgebung mit dem ISO-C3D bei Operationen der Halswirbelsäule

Meeting Abstract

  • corresponding author J. Baldauf - Klinik für Neurochirurgie, Ernst-Moritz-Arndt Universität Greifswald
  • S. Fleck - Klinik für Neurochirurgie, Ernst-Moritz-Arndt Universität Greifswald
  • J.U. Müller - Klinik für Neurochirurgie, Ernst-Moritz-Arndt Universität Greifswald
  • P. Hinz - Klinik für Neurochirurgie, Ernst-Moritz-Arndt Universität Greifswald
  • H.W.S. Schroeder - Klinik für Neurochirurgie, Ernst-Moritz-Arndt Universität Greifswald

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocFR.02.08

The electronic version of this article is the complete one and can be found online at:

Published: May 8, 2006

© 2006 Baldauf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: The intraoperative use of the mobile Siremobil Iso-C3D C-arm (Siemens AG, Medical Solutions, Erlangen) considerably improves the information available during cervical spine surgery. We report our early experiences with the Iso-C3D fluoroscopic unit.

Methods: Since June 2004 we have used the mobile Siremobil Iso-C3D C-arm in spine surgery. During surgery it can be used as a common X-ray control. But the main advantage is the intraoperative three-dimensional control of accurate fracture repositioning, spinal decompression, and correct screw, plate or cage positioning. The Iso-C3D acquires 100 fluoroscopic images during a 190° C-arm orbital rotation. The device calculates a 3D image data cube of the scanned region for the computerized reconstruction, with a length of 119 mm. From these data, multislice images (multiplanar reconstruction) with axial, coronal and sagittal slice orientation can be obtained. The process from C-arm rotation to 3D image reconstruction requires 120 seconds. The use of the Iso-C3D in 43 patients, including degenerative cervical stenosis (18), fractures (14), instability (3) and tumors (8) of the cervical spine, was analyzed.

Results: In 18 patients with degenerative cervical stenosis (one level disease: 14; two level disease: 3; three level disease: 1) 3D scanning was done to evaluate the extent of bony decompression and correct positioning of cages at the end of operation. In 2 patients insufficient bony decompression was noticed and surgery had to be continued. Successful decompression was proved thereafter by another scan. In 25 patients complex instrumented spine surgery was performed. Additionally, the system had been used in 4 navigated procedures. The sufficient fracture repositioning as well as the correct placement of the surgical implants was recognized in 23 patients after 3D scanning. In 2 patients surgery had to be altered because of incorrect placement of screws.

Conclusions: In 9% of all patients surgical procedure was altered intraoperatively because of ISO C imaging. Postoperative revisions could be avoided with the result of saving costs. The 3D-image acquisition with the Iso-C3D was easy and safe to perform. The image quality concerning the cervical spine was adequate and similar to a CT scan.