Singapore Offers Precision Guided Spinal Surgery

The Singapore General Hospital was one of the first medical institutions in the world to invest in the O-Arm navigation system for spinal surgeries when the US-developed technology was made available in late 2006.

Singapore (PRWEB) March 10, 2009

The Singapore General Hospital (SGH) - one of Southeast Asia's largest spine surgery centers (http://www. singaporemedicine. com/hcp/hcp1.asp) - has succeeded in achieving almost 100 percent accuracy in implant-related spinal surgeries with the help of advanced medical technology.

SGH was one of the first medical institutions in the world to invest in the O-Arm navigation system for spinal surgeries when the US-developed technology was made available in late 2006.

"We started offering spinal surgeries using this technology in mid-2007. Only about a dozen centers globally had the O-Arm system at the time," says Clinical Associate Professor Tan Seang Beng, Director of the Spine Service and Head of SGH's Department of Orthopaedic Surgery.

Costing about US$1 million, the mobile O-Arm Imaging System (http://www. singaporemedicine. com/leadingmedhub/leadingmedhub1.asp) is a multi-dimensional surgical imaging platform that is of great help in complicated procedures where metallic implants of various shapes and sizes have to be placed into the spine.

"Every year, SGH does hundreds of spinal operations, ranging from slipped discs to fractures to bone cancer cases. Repair work to the bone structure is often needed for patients who have hurt their spines in accidents, or through general wear and tear," explains A/P Tan.

Such repairs usually require some form of metallic implantation - most often, titanium screws, rods or even hooks.

"In implant-related surgeries, precision is extremely important. The bone or pedicle that will bear the implants may be just a few millimeters in diameter and the screws, for example, can be almost as large. If placement is not accurate, perforations may occur and that can result in quite serious damage to the surrounding tissues and nerves, not to mention the pain and costs involved when corrective surgeries must be done," says A/P Tan.

Since X-rays are only two-dimensional, a surgeon is often required to make a judgment call based entirely on his expertise, to decide if an implant is well-placed.

Because of this, between five and 30 percent of all pedicle screws inserted in the course of spinal operations (http://www. singaporemedicine. com/healthcaredest/sg. asp) worldwide have been reported to be misplaced, and some of these patients require repeat surgeries to re-adjust the position of the implanted materials.

"It is in everyone's interest to have a good fit at the first try and that's where the O-Arm comes in very useful. So far, we have performed more than a hundred surgeries with it and we are very satisfied with the outcome," says A/P Tan.

This "intelligent" system offers three-dimensional, intra-operative scanning, which means surgeons can periodically perform a scan during the surgery to accurately check the position of the implants.

"Now, all necessary corrective re-placement is done during the operation, before any damage can be done. The detection is as complete as it can get, and screw misplacement can be totally avoided using this technology," says A/P Tan.

According to him, the O-Arm is particularly useful for spinal surgeries (http://www. singaporemedicine. com/healthcaredest/healthcaredest1.asp) involving children.

"Because a child's bones are still in the growing stages, their bone sizes are relatively smaller compared to adults, and this makes the placement of implants more difficult. With the O-Arm, we will be able to pick and choose the ideal areas along the spinal structure for implantation," he says.

Those with abnormal anatomies such as a curved spine will also benefit from this firm of assisted surgery.

"The outcome of surgeries involving the spine is partially dependent on age and body proportion so for patients with unusual anatomies, precision-guided systems like this will be an obvious help," A/P Tan explains.

Accuracy aside, the portable O-Arm also emits less amounts of radiation compared to conventional CT scans. Cost, too, is a big draw.

"In Singapore, the Government has a fund we can tap for new medical technologies, so the investment costs don't get passed on to our patients.

"Here, it makes no difference whether you opt for implant surgery with or without the O-Arm technology. We don't charge extra just for using this system," says A/P Tan.

A typical spinal operation in Singapore costs about US$15,000 (http://www. singaporemedicine. com/intl_pts_guide/preparation. asp), compared to about US$70,000 for a similar operation in the US.

About the Singapore General Hospital

The Singapore General Hospital (SGH) is the public sector's flagship hospital. Established in 1821, SGH is Singapore's largest and most established acute tertiary hospital and national referral centre. A multi-disciplinary approach to medical care offers patients ready access to a wide range of specialties and support services. SGH achieved Joint Commission International (JCI) accreditation in 2005 - the largest teaching hospital in Asia to be accorded such recognition. (www. sgh. com. sg])

About SingaporeMedicine

Launched in 2003, SingaporeMedicine is a multi-agency government-industry partnership committed to strengthening Singapore's position as Asia's leading medical hub and international health care destination (http://www. singaporemedicine. com/). Led by the Ministry of Health of Singapore, SingaporeMedicine is supported by three government agencies: the Economic Development Board, which develops industry capabilities, the International Enterprise Singapore, which fosters regionalism by Singapore-based health care players, and the Singapore Tourism Board, which markets Singapore as a healthcare destination to inbound international patients and develops associated people-oriented services. (www. singaporemedicine. com])

###