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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Visualization in tubular assisted spinal surgery. Is there a difference between HD-endoscopy and microscopy?

Meeting Abstract

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  • Benedikt Burkhardt - Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
  • Melanie Wilmes - Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
  • Salman Sharif - Karachi, Pakistan
  • Joachim Oertel - Universitätsklinikum des Saarlandes, Medizinische Fakultät der Universität des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP 007

doi: 10.3205/17dgnc570, urn:nbn:de:0183-17dgnc5704

Published: June 9, 2017

© 2017 Burkhardt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: Expert spinal surgeons criticized endoscopic procedures for poor image quality, in comparison to microscopic visualization. The recent introduction of high definition (HD) digital cameras has shown good results in spinal endoscopy. The aim of this study was to assess endoscopic HD image quality in comparison with microscopic visualization.

Methods: All posterior lumbar and cervical spinal surgeries of this study were performed in HD resolution. For each comparison, anatomical structures were predefined intraoperatively. A junior resident was randomly required to enter the operating theatre and to identify those structures either using HD-endoscopic or microscopic visualization through the endoscopic working sheath.

Results: Thirteen lumbar and three cervical procedures were performed. Thirty-four comparisons with a total of 214 predefined anatomical structures were analyzed. The number of predefined structures ranged from 5 to 9 per surgical field. Out of 214 predefined structures, 124 structures (65.8%) were correctly identified under endoscopic view and 88 (41.1%) under microscopic view (p< 0.001). The view onto the surgical field via endoscopic visualization was assessed superior to microscopic visualization (p< 0.001).

Conclusion: When using a working trocar and live images, endoscopic HD camera imaging accounted for significantly more reliable identifications of anatomical structures compared to the microscopic view. The subjective impression of video quality is significantly better with HD-optics. The goal of further studies should be to evalute if these findings results in improved surgical outcome.