Archive May 2016 XVII, No. 5

Thinking of Buying ... A Spine Surgery Table

What surgeons want, plus a roundup of 7 leading spinal tables.

Nitin Khanna, MD

BIO

If you're looking to outfit your OR with a table that supports minimally invasive spine, ask your surgeons what types of cases they'll be performing and what they need the table to do. Whether they bring anterior cervical discectomies, lumbar decompressions, kyphoplasties or lumbar interbody fusion to your ORs, they'll probably all mention 3 factors.

  • Radiolucency. A traditional OR table is constructed in part from metal components, and metal components will obscure visualization during intraoperative fluoroscopic imaging. Tables designed specifically for imaging, including spine specialty tables, incorporate carbon fiber structures for radiolucency.
  • C-arm compatibility. Because minimally invasive spine relies on intraoperative imaging, the table you're operating on should allow C-arms, X-ray machines, O-arms and other imaging equipment in and out of the field. A cantilevered table that extends out (with a sufficient working weight capacity) from a base at the end of the table is ideal, but make sure it will let equipment reach the patient's cervical spine.
  • Positioning flexibility. Imaging isn't the only method of anatomical exposure and access during spine surgery. Patients are placed in multiple positions: prone, supine and lateral decubitus positions, bent and flexed, tilted to the side and even turned over, sometimes during the course of the case. How easily and effectively can the table you're considering do this? In addition to tables themselves, some manufacturers offer table accessories that can retrofit a traditional OR surface into one that can handle specialized spine tasks. While these may offer an economical solution, first find out whether these add-ons are cumbersome to attach and difficult to position, which could lengthen OR times.
  • One other aspect that's important for facilities to consider when buying a spine table is whether it is forward-compatible. The future of minimally invasive surgery is likely to involve the increased use of robotic techniques and intraoperative CT-scanning navigation systems, among other technologies. Outpatient surgery will be driving the demand for these innovations, and the outpatient OR is where they will happen. Will the tables you choose today be able to adapt to the needs of tomorrow? For the most useful table, anticipate its long-term use and the next big things that may arrive in your ORs. OSM

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