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Archive June 2018 XIX, No. 6

Is It Time to Replace Your C-arm?

The newest machines represent a phenomenal improvement.

Richard Broderick

Richard Broderick, MD, FACS, FAANS


10X MAGNIFICATION Some new C-arm technologies that can magnify images up to 10 times let you see extremely small and subtle findings that you never would have been able to see before.

A couple of months ago, I did a spine operation on the kind of large patient we see increasingly frequently these days. Only, this patient was even more extreme. He was a young man who tipped the scales at 470 pounds. In the old days — say, a decade ago — I wouldn't have bothered to bring a C-arm into the OR. Why waste everyone's time when you know there's no chance you'll be able to see the patient's spine?

Times have changed. Welcome to the new world of C-arms, where recent advancements in technology are nothing short of remarkable. Among other things, newer C-arms are powered in such a way that you can shoot X-rays through some of the largest human beings on the planet, and still get the vivid pictures you need. By making surgery dramatically safer and more efficient, as well as affording several other advantages, they've become, in my opinion, vital investments for clinicians who are committed to providing the best care possible.

Seeing is believing

I recently went through an evaluation process and helped guide the purchase of a new state-of-the-art C-arm fluoroscopy unit for my hospital's outpatient surgery center. The advantages and innovations with the new machines are many, but they start with the visuals. Simply put, they put the "see" in C-arms.

Those of us who've been practicing for more than a few years remember working with grainy pictures on monitors that were at best equivalent to standard TV monitors. The ability to see what you really needed was very limited. And if you happened to have a heavier patient, you really couldn't see anything because the machine didn't have enough juice to get the X-rays through the patient.

Most newer units not only have fairly large 4K monitors (about 20 inches) that display beautiful, vivid visuals, no matter how large the patient is, they also let you connect the output from the C-arm to the monitor of your choice. In other words, if you have a 40- or 50-inch ultra-high-def monitor on your wall or boom, you can get an even bigger and bolder view of the anatomy you're working with.

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