The marriage between the fluroscopic guidance and percutaneous spine surgery
The importance of accurate and high fidelity visualisation of the interbal hunan structures is critical to the performance of a safe and effective procedure. It is essential that the surgeons understands the and is able to convert 2-D radiological images into 3-D anatomical structures which would thus alllow the operator to know exactly on which part of the anatomy they were operating.
Prior to the advances of enhanced imaging techniques, most surgeries were performd by subjecting the patient to a wide aggressive dissection associated with large blood loss and infection with outcomes that were prolonged and sometimes unpredictable. However the last decade had witnessed a drastic paradigm shift in the approach to the treatment of spinal disorders and it can be confidently stated that a large part of this is accounted for the improved use of fluroscopic guidance and interptetation. FGI-Fluroscopic and guidance are the mainstay of perceutaneous spine surgery, without which the surgeries would be impossible. As fluroscopic units have developed their ability to image,the situation has advanced to the point where surgeons can obtain hight fidelity never imagined.
The effective implementation of the C arm requires both training and natural appitude with some surgeons able to master the skill rapidly while others will struggle for years trying to correlate the 2-D radiological images with the 3-D anatomical images. This type of stereotactic skill is the one that proficient video gamers harnes, and certain studies have shown that if a surgeon regularly plays a video game before a surgery his outcomes improve, no doubt because he has opened up the necessary pathways required for rapid tempero-spaitial thinking, which it is importnat to add is not a skill that is either taught or required in the spine surgery that most likely dated 2006. Since 2006 the trend towards radiolgically guided percutaneous spine surgery has been increasing and it is expected to do so for the next decade.
The professional batttles between the orthopedic, neurosurgical,IP and radiological communities will be forced to adop a very different narrative as the intervetionalists with their superior raiological skills will be the ones most qualified to perform the procedures of percutaneous spine surgery/intervention
