Dr. Mirza agreed, saying that research will prove whether such advanced technology is worth the extra cost. “This technology is growing, and we don’t think every procedure will always benefit from using it, “ he said. “We want to carefully study this kind of technology so we can assess its value. It is expensive up front, but if it saves lives or avoids a second surgery, then the value will be there.”
Explore This IssueMay 2015
Because of the strong pull of the magnets used in MRIs, it’s crucial to use compatible tools. Typical surgical instruments, which are made of stainless steel, would become dangerous projectiles in an MRI suite. Any other personal metal items—watches, barrettes, and the like—must also be kept out of the MRI area. And, the materials that are used must be pared down to what is the most essential, said Dr. Mirza.
“Typically, we use 150 to 200 instruments in a spinal surgery, but in the intra-operative imaging suite, we use 30 to 40 instruments that we will count and put on the table,” he said. “We’re paying so much attention to padding and positioning, so we had to do some really hard work to streamline our surgical instrument trays to ensure we aren’t counting hundreds of instruments multiple times during a surgery,” he said. The nursing staff also needs to be trained to work on patients who are having such imaging done.
Another drawback of being overly reliant on imaging is that it can be imperfect, said Dr. Smith. “Surgery still comes back to the basic principles of understanding the anatomy [and] the pathology and safely manipulating that in a surgical fashion based on more than what a computer is telling you,” he said. “It’s adjunct information that allows one to proceed with additional information that can, in certain instances, really make the difference [in] whether a surgery can be executed or not.” Relying too closely on the images without using surgical skill could create problems, he said.—CA