Novel Application Instantly Confirms Spinal Implant Placement

A new software application allows for quick verification of spinal implant placement, and reduces the potential for revision cases due to misplaced pedicle screws.

The Renaissance C-OnSite software application can be used with any commonly found two-dimensional (2D) C-Arms, which are standard equipment in spine operating rooms. Rotating the C-arm for 15 seconds around the implant site provides sufficient data to create a three-dimensional (3D) reconstruction, from which measurements can be made and the overall procedure analyzed. If issues are discovered, corrective steps can be taken immediately, rather than as a revision case a few days later. The process requires no more than 5 to 10 minutes of additional OR time.


The 15-second C-Arm rotation scan is performed after screw positioning, and the images are fused with high-quality images from the preoperative computerized tomography (CT). This produces an intraoperative 3D axial view of the spine, showing the exact location of each pedicle screw and its relationship to the spinal canal, without additional, expensive intra-operative 3D systems for spine surgery. The Renaissance C-OnSite software application is a product of Mazor Robotics (Caesarea, Israel), and has already been incorporated into the company’s Renaissance surgical guidance system.

“Renaissance C-OnSite combines the enhanced accuracy of robotic guidance with actionable, intraoperative 3D image-based verification of screw positioning for immediate evaluation and correction,” said Ori Hadomi, CEO of Mazor Robotics. “By delivering post-op information during the surgical procedure, C-OnSite makes Renaissance a full solution for the spine surgeon, from pre-op planning through surgical guidance to verification.”

“The patient gets the equivalent of a post-op CT before leaving the operating room without the high radiation levels, and does not have to wait to rule out the need for revision surgery,” said Payam Moazzaz, MD, an orthopedic spine surgeon at TriCity Medical Center (Oceanside, CA, USA).

Currently, the most common way to accurately verify the placement of pedicle screws is by postoperative CT. But since it takes place after the surgery has been completed, significant misplacements necessitate a revision surgery. Intraoperative imaging systems are usually 2D, which is not sensitive enough for verification purposes, and 3D systems are not very common and are very expensive.

Related Links:
Mazor Robotics
TriCity Medical Center