title: Use of the video telescope operating monitor (VITOM) as an alternative to the operating microscope in spine surgery.
abstract: METHODS
  Prospective cohort study.
  
  
  OBJECTIVE
  To evaluate the efficacy of video telescope operating monitor (VITOM) as an alternative to operative microscope (OM) in spinal surgery.
  
  
  BACKGROUND
  The surgical operating microscope can be expensive, cumbersome, and ergonomically disadvantageous. VITOM is a novel telescope-based exoscope system that can be used as an alternative or supplement to OM.
  
  
  METHODS
  Patients undergoing spinal surgery were enrolled in a prospective cohort study between December 2008 and March 2011. Age, sex, and operation-matched patients undergoing surgery using the standard OM served as the control group. During surgery, the VITOM system was used in place of the OM in 24 patients. Operative time, length of postoperative hospital stay, and intraoperative complications were assessed. RESULTS.: A total of 48 patients were studied in 2 equal cohorts of 24 patients each. Within each cohort, patients underwent single-level (n = 4) and 2-level (n = 7) posterior decompression as well as single-level (n = 11) and 2-level (n = 2) transforaminal lumbar interbody fusions via VITOM, with an equal number of controls using OM. There were no significant differences in age (P = 0.79) or sex (P = 0.77) between cohorts.There were no statistically significant differences in mean operative room time for single-level decompressions (P = 0.38), 2-level decompressions (P = 0.12), single-level transforaminal lumbar interbody fusions (P = 0.13), or 2-level transforaminal lumbar interbody fusions (P = 0.15). Postoperative hospital length of stay averaged 2.9 days for the VITOM group versus 2.8 days for the traditional OM group (P = 0.75). There were no intraoperative complications in either group. Subjectively, surgeons rated the image quality as very high and equal to the OM.
  
  
  CONCLUSIONS
  The VITOM system for spinal surgery provides outstanding image quality and an ease of manipulation rivaling the OM. There were no statistically significant differences in mean operative room time, intraoperative complications, or total hospital length of stay when using this novel system in several common spinal procedures relative to the OM.
authors.affiliation: Cedars-Sinai Medical Center, 444 South San Vicente Blvd., Los Angeles, CA 90048, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Shirzadi
authors.forename: Debraj
authors.initials: D
authors.lastname: Mukherjee
authors.forename: Doniel G
authors.initials: DG
authors.lastname: Drazin
authors.forename: Michelle
authors.initials: M
authors.lastname: Paff
authors.forename: Brian
authors.initials: B
authors.lastname: Perri
authors.forename: Adam N
authors.initials: AN
authors.lastname: Mamelak
authors.forename: Khawar
authors.initials: K
authors.lastname: Siddique
mesh_terms: D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013131:Spine / Q000601:surgery*; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*