Published, 28.08.2022
85% of the population will experience lower back pain at least once in their lifetime (Schmidt et al., 2007). For those affected, fast and effective pain relief is crucial. In cases of severe or prolonged complaints, it is important to find a competent doctor who can conduct a thorough examination and take all the necessary steps for a comprehensive diagnosis. Specific causes of pain related to spinal disorders must be ruled out, or in some cases, further spinal surgery may be required. But where should a patient with a vertebral fracture, tumor, infection, or neurological deficits seek treatment? The best option is a doctor or therapist who can offer high-quality, carefully planned, and personalized treatment for the individual’s condition.
Experience from the spinal outpatient clinic shows that a detailed consultation in clear, understandable language, along with information about the planned treatment, helps alleviate patients’ fears of surgery and fosters a positive doctor-patient relationship. In this regard, the patient’s own imaging (CT, X-ray, MRI) can be especially helpful. A three-dimensional representation of the surgical plan, including all related implants, is easier to understand than abstract sketches typically found in standard patient information leaflets. Even for medical laypersons, complex issues can be clarified using 3D illustrations from different angles, making them more comprehensible. When the condition does not involve acute emergencies, such as a spinal fracture with accompanying neurological injuries, the patient will likely choose their doctor or hospital based on the consultation.
Planning in Spinal Surgery – Similar to Preparing in a Flight Simulator
If non-surgical treatment options have been exhausted, Klinikum Südstadt Rostock uses the 3D planning software mediCAD Spine® 3D from mediCAD Hectec GmbH for instrumented spinal surgeries. Dr. Maximilian Reinhold, a specialist and senior consultant in spinal surgery, explains the advantages of 3D surgical planning and makes an interesting comparison with the aviation industry:
“As a practicing colleague or doctor in employment, you are increasingly faced with organizing your working hours and using them as efficiently as possible. Errors caused by time pressure during patient care, clinical examinations, or surgery should be minimized or avoided. But how? One of the professions with the lowest error rates is professional aviation (Müller, 2004). Medicine can learn a lot from this field. For this reason, alliances and cooperation projects have emerged in recent years between medical associations and aviation companies (www.dkou.de / www.lufthansa-flight-training.com).”
Good time management (dispatch), error correction, and error prevention strategies (cockpit resource management), as well as the use of evaluated checklists, have been standard practice in commercial aviation for years and are now increasingly being implemented in hospitals and operating rooms. Thorough planning of each ‘flight’ (or surgery) and regular training of pilots on realistic computer simulators are of particular importance. Realistic scenarios (take-offs, landings, emergency maneuvers, and procedures) are simulated to ensure quick and correct reactions in emergencies. This effectively minimizes the risk of errors with serious consequences (Müller, 2003).
Surgical planning with digital planning software like mediCAD Spine® 3D is similar to flight preparation: all the necessary surgical steps and the required implants are “simulated,” or mentally rehearsed from start to finish. The automatically generated planning protocol summarizes all the essential information and is immediately available.
The risk of a ‘crash landing’ in the operating room is minimized—you are better prepared! Not only that, but the demonstration of the 3D-generated graphics with mediCAD Spine® 3D allows for better patient consultations, building trust and creating a strong foundation for further treatment steps. Well-informed patients have high expectations for elective surgeries, and receiving well-grounded information is crucial. Today, it’s normal for patients to seek second opinions and consult with multiple colleagues, which is also supported by health insurance companies. The quality of the consultation is often the decisive factor in the patient’s choice of doctor and their decision.
The additional time spent on 3D planning with mediCAD Spine® 3D is a worthwhile investment, especially for complex spinal surgeries, and later pays off with smoother workflows in the operating room. At an hourly rate of €100, a minute of preoperative planning costs €1.70, while an operating room minute costs significantly more—already estimated at €40-50 in 2012 (Fleischer, 2012).
Computer-aided planning of spinal operations is not currently required by law. However, with the mediCAD Spine® 3D planning software, one is well-equipped for the future. Developments over the last two years have shown that spinal surgery is increasingly aligning with the standards and requirements of orthopedic surgery (e.g., the endoprosthesis register, with mandatory surgical planning) and trauma surgery (e.g., trauma registers). In this context, only the personal certifications (basic/master’s certificates) and, since January 2017, institutional certification options of the German Spine Society (DWG) (Spine Center I-III) are available. mediCAD Spine® 3D is integrated as a software module into the practice’s or clinic’s HIS/PACS system, facilitating seamless documentation. System and software support is provided by the manufacturer, mediCAD Hectec GmbH, and is available on short notice (support@mediCAD.de or +49 871 330203-0).
mediCAD Spine® 3D is a valuable, medically and economically sensible tool that meets both the high standards of the practice and the expectations of the patients, and should not go unused. Personally, I use the software to prepare for every instrumented spinal operation, which gives me more confidence. The workload is accounted for by the payers and is listed in the DRG catalogue as procedure 5-83w.20 (G-DRG system 2017).”
mediCAD Spine® 3D –
das leistungsstarke Tool in der Wirbelsäulenchirurgie
As the global market leader in digital surgical planning, with over 20,000 clinical users of mediCAD®, mediCAD Spine® 3D is an innovative tool that offers the physician optimal, audit-proof, and modern surgical preparation in spinal surgery. The software simplifies the neurosurgeon’s daily routine in preoperative planning and stands out with the following features:
Research and development are of particular importance to mediCAD Hectec GmbH. The further development
and continuous improvement of the software are always at the forefront.
In close cooperation with renowned spinal surgeons, the product developers and software engineers at mediCAD Hectec GmbH, along with experts from various medical fields, continuously enhance and refine mediCAD Spine® 3D. For example, Dr. Reinhold and Klinikum Südstadt Rostock are conducting a prospective clinical-radiological study on the new preoperative planning system in spinal surgery.
The study was approved by the ethics committee of the University of Rostock in February 2017. The first patients have been included, and the data is currently being analyzed. The aim of the study is to precisely evaluate the software module in everyday clinical practice. For preoperative planning with mediCAD Spine® 3D, only the standard and already available digital X-ray and CT images of the affected area are used, and these are compared with the actual postoperative treatment results. Aspects of the planning process, such as the duration of planning, potential errors, and program inadequacies, as well as the intraoperative procedure (including the implants used, possible problems, and intraoperative peculiarities), are recorded and analyzed.
The knowledge gained from the study is intended to contribute to improving the treatment procedures for patients requiring spinal surgery and to further develop and optimize the software—particularly regarding its functionality in routine clinical use. Only through such real-world studies and tests of the software, following mediCAD Hectec GmbH’s motto “Development with Doctors for Doctors,” can mediCAD Spine® 3D—with its well-conceived product concept and ease of use—improve the quality of patient treatment and simplify work in daily clinical practice.
To the author:
Priv. Doz. Dr Maximilian Reinhold, MBA is a specialist in trauma surgery, orthopaedics and orthopaedic surgery and works as Ltd. OA Spinal Surgery at the Klinikum Südstadt Rostock. Dr Reinhold is a private pilot (PPL SEP, MEP IR). He flies single and twin-engine propeller aeroplanes.
Kontakt:
Klinikum Südstadt Rostock, Clinic for Trauma Surgery,
Orthopaedics and Hand Surgery
Südring 81, 18059 Rostock
Phone: +49 (0)381 44014101
email: info@dr-reinhold.com
www.dr-reinhold.com
mediCAD Hectec GmbH
Since 1994, mediCAD Hectec GmbH has been providing software solutions for orthopedic surgeons, with the aim of enabling efficient and safe digital planning of joint operations—both in clinics and private practices. In 1999, mediCAD Hectec GmbH became the first company in the world to offer software for complete preoperative planning of joint replacements in a digital environment with just a few clicks.
With mediCAD®, the company has set an innovative milestone in supporting orthopedic surgery on a global scale. Through the automatic archiving of all necessary information, consistent traceability of findings, surgical preparation, and post-operative care, mediCAD® provides the ideal solution for surgeries that are optimally prepared, professionally performed, and documented in an audit-proof manner.
Thanks to close cooperation with leading medical technology companies and the successful use of mediCAD® in over 4,000 clinics worldwide, mediCAD Hectec GmbH—with approximately 50 employees—has already established itself as one of the global players in the field of medical software solutions.
mediCAD Hectec GmbH
Opalstr. 54 | 84032 Altdorf / Landshut
Phone +49 871 330 203-0 | info@medicad.eu
www.medicad.eu
References:
¹ Fleischer, W. (2012). OR Organization: First Aid for the Heart of the Hospital. *German Medical Journal*.
² Müller, M. (2003). Risk Management and Safety Strategies in Aviation – A Model for Medicine? *Journal of General Medicine*, 79, 339–344.
³ Müller, M. (2004). Every Mistake Counts! *MDK Forum*, (3), 1–9.
⁴ Schmidt, C. O., Raspe, H., Pfingsten, M., Hasenbring, M., Basler, H. D., Eich, W., & Kohlmann, T. (2007). Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey. *Spine*, 32(18), 2005–2011. http://doi.org/10.1097/BRS.0b013e318133fad8
