O-arm failure traps patient prone on a Jackson table.
The O-arm Surgical Imaging System (Medtronic Sofamor Danek, Memphis, TN, USA) is an increasingly popular tool for spinal surgical procedures that allows for intraoperative acquisition of multi-dimensional spinal imaging that can be used either to confirm placement of spinal instrumentation or to guide spinal screw placement in conjunction with a navigation system. The machine is typically placed open from the side of the patient positioned prone on the Jackson spinal table (Mizuho OSI, Union City, CA, USA) and then closed to complete a ring around the patient to acquire images. A failure of the O-arm opening mechanism can lead to a patient becoming effectively trapped within the device with limited physician access to the patient's body, a situation that may be remedied by using a manual opening procedure. This report highlights a patient safety issue encountered when a mechanical failure of the O-arm occurred and one of the two tools required for its manual opening was missing. We describe the improvised method employed to successfully open the device.
Department of Anesthesiology, Albert Einstein College of Medicine, Yeshiva University, Montefiore Medical Center, Bronx, NY, USA.
Sergey
S
Pisklakov
Department of Neurosurgery, Albert Einstein College of Medicine, Yeshiva University, Montefiore Medical Center, 111 East 201st Street, Bronx, NY 10467, USA. Electronic address: jkhmd@yahoo.com.
John K
JK
Houten
Department of Neurosurgery, Albert Einstein College of Medicine, Yeshiva University, Montefiore Medical Center, 111 East 201st Street, Bronx, NY 10467, USA.
Murray
M
Echt
Department of Anesthesiology, Albert Einstein College of Medicine, Yeshiva University, Montefiore Medical Center, Bronx, NY, USA.
Angelika
A
Kosse
Department of Anesthesiology, Albert Einstein College of Medicine, Yeshiva University, Montefiore Medical Center, Bronx, NY, USA.
Apolonia E
AE
Abramowicz
D000368:Aged; D004868:Equipment Failure; D006801:Humans; D008297:Male; D038361:Neuronavigation / Q000009:adverse effects* / Q000295:instrumentation*; D013123:Spinal Fusion / Q000295:instrumentation; D025321:Surgery, Computer-Assisted / Q000009:adverse effects* / Q000295:instrumentation*
Image-guided surgery; Navigation; O-arm; Patient safety; Pedicle screw; Spinal surgery