The All India Institute of Medical Sciences’ (AIIMS) Trauma Centre successfully fixed a 32-year-old man's broken neck on April 14.
What made it possible was the Centre's recently procured multi-dimensional imaging system called the O-arm that provides real-time 3-D images of the vertebral column patient on the operation table.
“Normally we would have fixed the spine in what we call a blind procedure. Inside the OT, we could only imagine the structure of spine while fixing the broken bone with screws; we only had the x-ray images to rely upon,” said Dr Deepak Aggarwal, assistant professor neurosurgery, AIIMS Trauma Centre, which has become the first hospital in south Asia to do a spine-related procedure using the machine.
The man broke his neck in an accident in Nainital and was brought to Delhi for treatment.
“It was a risk, as chances of accidentally hitting the spinal cord were high.”
The equipment is especially valuable at a training institution such as AIIMS, where guided by accurate images, a junior surgeon can achieve results equivalent to that of an experienced surgeon. This reduces the risk of revision surgeries.
“The only way to check whether the surgery went well was to get a post-operation CT image, after the patient was out of OT. If a fault was found in the procedure, the patient needed to undergo corrective surgeries,” said Dr Aggarwal.
Another advantage of the O-arm is that it reduces the need to take multiple X-rays.
“A single 3-D image is enough for the entire procedure, which significantly reduces radiation exposure to the people inside the OT,” said Dr Aggarwal.
The machine is useful for gunshot and missile injuries too, where surgeons would choose to leave the bullet or missile splinters inside the brain for unavailability of sophisticated imaging system to accurately locate them.
“It wasn’t feasible earlier to cut open the brain to manually locate the bullet, so we would prefer leaving it untouched. But with this machine, we can get the correct position of the particle inside,” said Dr Aggarwal.
The Rs 4 crore machine was introduced in the US two-and-a-half years ago, and the Trauma Centre acquired it early this month.
After the first surgery on April 14, the Centre operated five more cases with optimally accurate results.
“I’m proud to say all the patients are doing fine post-surgery,” said Dr Aggarwal.