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SPiN Thoracic Navigation System™ used for Rib Fracture Localization

LOCALIZATION OF RIB FRACTURES WITH SPIN PERC™
Author
Dr. Karen Gersch

Cardiothoracic Surgeon

Trident Medical Center

Charleston, SC

Patient Information: 68 y/o, F

Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol

Instruments Used: Always-On Tip Tracked® Guidewire & SPiN Perc™ Navigated Stylet

Conclusion: Successful localization of rib fracture sites and plating procedure

Observations

“I would have made my incision lines completely differently if I had not localized these fractures using Veran. The targets were spot on and saved me from making unnecessarily large incisions to identify the fracture sites.”

Patient History
This female patient fell from a ladder while working in her garage. She was transported to Trident Medical Center with acute traumatic chest injuries. Dr. Gersch was brought on this case to evaluate injuries and plan for treatment. Diagnostic imaging revealed four fractures on ribs 4-8 on the patient’s right side. Instead of scheduling the patient for an additional procedure in IR, Dr. Gersch decided to use Veran to assist in localizing and marking the fracture sites.

Planning
The patient was scanned in the right lateral decubitus position using Veran CT scan protocol. Upon reviewing the CT scan, Dr. Gersch identified and dropped spheres to mark the locations of the fractures using SPiN Planning™ software.

Procedure
The patient was taken to the operating room for an internal rib fixation procedure. After the patient was positioned in the lateral decubitus position and prepped for surgery, Dr. Gersch first used the Always-On Tip Tracked® Guidewire to perform endobronchial registration. The procedure transitioned to SPiN Perc™ for cutaneous localization of the rib fractures in order for Dr. Gersch to accurately plan her incision sites. Using the SPiN Perc™ navigated stylet, she marked the location of each fracture on the patient’s skin. After the Veran portion of the procedure, Dr Gersch successfully plated each fracture site and noted each fracture site was accurately correlated with the Veran marking.

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