Cios Spin and NuVasive Quick Guide

SIEMENS Healthineers 20 3D ONUVASIVE ealthineers Cios Spin Quick Guide O O Spine Precision Partnership Spine Precision NUVASIVE * PartnershipTM * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Table of Contents Application Group and Application 3 Preparation for Working with Cios Spin and Pulse* 4 Patient Positioning, Table and Drapes 5 Lessray 6 3D ONUVASIVE Stitching on Pulse* 7 Patient Preparation for 3D Scan 8 SIEMENS Cias Spin NaviLink 3D Workflow 11 Patient Positioning Must Be Correct 12 O For navigated 3D – Collision Check 13 For navigated 3D – Choose Extra power: Obese 14 For navigated 3D – When to choose Navigation/No Navigation 15 2 * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Application Group and Application Application group Application Use For Large Patients Use: For Small Children Use: Application group Ortho Application group Ortho Application group Pediatric With: With: With: Application Ortho Standard Application Ortho Adipose Application Pediat. Standard Application Ortho Spine Application Pediat. Spine 3 Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Preparation for Working with Cios Spin and Pulse* An ethernet cable to connect Cios Spin and Pulse needs to be available (Pulse team/hospital). The C-arm with NuVasive* reference-markers on the FD has to be draped in a special way. The markers have to be visible to the camera despite any drapes. Markers may not be covered by the drape. CIRCAL UNE To improve visibility of Cios Spin laser light, place the Cios Spin and OR light, so that no OR SIEW ENS Health leers light shines in the field of view. This helps to see the laser light. The OR table used with Cios Spin and NuVasive Pulse* must be radiolucent in the area used for 2D and 3D. 4 * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Patient Positioning, Table and Drapes Patient Positioning Talk with the surgeon and the nurses about the space under the table and how to fix moving drapes for the time of the 3D Scan. Ideally, this is conducted during draping time at the beginning. All tubes, wires, lines and anything that may hang down from the OR table should be strapped up to the underside of the table, allowing for non-impeded movement of the Cios Spin underneath. Mid to upper thoracic scans may create patient arm board collision scenarios. This should be highlighted to the surgeon and the anaesthetisiologist before the patient is positioned, so the arm boards can be set up correctly prior to draping. This should ensure that any pending collision issues are mitigated for the time of 3D acquisition. Extra Cushioning Be aware that any additional cushions underneath the patient can make 3D scanning more difficult. Make sure that the region of interest (spine + possible marker) can still be in the isocenter of the C-arm during a 3D Scan without collisions. 5 Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Lessray* Make sure dose regulation is finished (yellow frame on left Cios monitor disappeared) before saving Orb. 0º p/s uGy m2 hh:mm:ss KV mA Dose Magnify Tech lock C Fluoro 7.5 150.76 00:00:47 58 17 Low Mag 0 Auto Quick Screen X Ang. 0º access shot images for Lessray using the Learn button. Live Tools An ethernet cable connection is needed for Lessray. + Learn Save Live Stitch Show Alignment Image Enhancement + / Alternate Metal Boost C O 7 6 * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Stitching on Pulse* For Stitching, prepare Cios Spin for a parallel movement along the patient to the structure of interest (for example spine). Check that there is no rotation of the image set up. Stitched images (screenshots) can be stored at Cios Spin. However, screenshots taken with Cios Spin cannot be exported with the current version. Please note: This is a known issue that will be addressed in future Cios releases. There is no workaround on Cios. 7 * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Patient Preparation for 3D Scan Important for Surgeon and Anaesthesiologist It may be necessary for patients to hold their breath. Before surgery, this needs to be discussed with the surgeon. The surgeon clarifies the possibility of a breath hold with the anaesthesiologist. Oxygenation or other medication might be needed before starting the 3D Scan. The anaesthesiologist has to be aware that it will take 30 or 60 seconds of breath hold in expiration. 8 Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide: SIEMENS Healthineers Patient Preparation for 3D Scan – Estimated 3D FoV You can use Mag 1 to display a white marker box on the 2D image. Cios Spin 846, Emergency 846, Emergency E 846 14-10-2021 14-10-2021 12:36:01 PM E_846 After clicking Mag 1, a white box will be displayed on the current image. No new Ortho Agip-a image needs to be acquired. Take one shot in 0° angulation and click Mag 1 to check if relevant anatomy and tools are within the inner area. The orange box (see image on the right) is the rough border for 3D FoV. Only the Orbital 0º white box is displayed on Cios. Angular 0º 15.3 mGy - 240.77 uGy*m2 Click Mag 0 to ensure that the next image will be taken 00:02:31 hh:mm:ss In full size again. Repeat the steps at 90° angulation. - This can help to define the 3D FoV. Single Image Fluoro Please note: This is just a rough estimation. - -- 0,11 HGy*m2 60.8 kV 52 x 1952 XYZ 0.13 mAs DR D: 0.139 LUT 2 Mag 0 Edge 2.50 SW vers. incompatible, SC 37: 1/1 WW: 4095 Ortho Adipose WC: 1600 9 Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Patient Preparation for 3D Scan – Estimated 3D FoV (Example) 0° Image + Mag 1 white box 90° Image + Mag 1 white box 846, Emergency Cios_Spin E 846 14-10-2021 14-10-2021 12:32:27 PM 46. Emergency 5 846 Cios Spin B46, Emergency Cios Spin 14-10-2021 12:36:01 PM 14-10-2021 14-10-2021 12:37:28 PM O 0.21 pGy 63.1 kV 0.25 mAs D: 0.139 Mag O rtho Adipose WC 1600 Ortho Adipose WC: 1600 The content in the orange area (not shown on Cios) gives a rough 3D FoV prediction. 1020 x 1020 35: 1/ CAP 10 Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers NaviLink 3D Workflow Please note: When navigation is being prepared on Pulse* + Cios, do not perform any other actions on Pulse main monitor or additional UIs. This could interrupt the navigation preparation. Registration Overview Select Type ¥ Capture Array(s) Load/Register Patient Data Orb. 95º × Registration Type Ang. 0º Store position Select patient orientation Single Fiducial Dual Fiducial Cios Select system position Registration Name Registration in Progress 80 O uGym2 KV NaviLink Caudal Array 00:00:00 1 NaviLink O hh:mm:ss mAs Patient orientation System position Caudal 0 NaviLink Collimator Laser Reset timer Supine Prone Fluoro Single 3D image Scan Left Right Sub Road DCM Medium Auto Dose Metal Tech lock correction Mag 0 3p/s Configure Scan Patient System Collision Check Scan Next Magnify Motion Noise filter Pulse rate Relation 11 * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers Patient Positioning Must Be Correct Orb. 95º X Ang. 0º Store Select patient orientation position 80 Select system position O uGym2 KV Please note: NuVasive* 00:00:00 1 hh:mm.c Patient orientation System position navigation highly * depends on correct Collimator Reset timer Supine Prone patient positioning. Fluoro Single 3D image Scan Left Right 6 Sub Road DCM Medium Auto Dose Metal correction Tech lock Mag 0 3p/s Magnify Motion Configure Scan Patient System Collision Check Scan Noise filter Pulse rate Relation 12 * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers For Navigated 3D – Collision Check When Using Pulse* Navigation Orb. 0º × Talk with the surgeon and the nurses about the space under Ang. 0º Store Select scan quality position the table and how to fix moving drapes before starting 3D 80 Select navigation O Scan. The best time for a collision check will be during the uGym2 KV draping time in the beginning. 00:00:00 1 hh:mm:ss mAs Scan quality Navigation * Extra power: Obese 60 400 Images No Navigation Collimator Laser Reset timer Fluoro Single 3D High quality image Scan Ö 30s 400 Images Standard Sub Road DCM 30s 200 Images Medium Auto Low dose Dose Metal Tech lock Ö30s 100 Images correction Mag 0 3p/s Configure Scan Patient System Magnify Motion Collision Check Scan Noise filter Pulse rate Relation 13 * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers For Navigated 3D – Extra power: Obese Choose Extra power: Obese. Orb. 0º × Please note: When using Pulse* navigation, the scan will take an Ang. 0º Store position Select scan quality extra 15 seconds after pressing the foot pedal until x-ray starts. In 80 Select navigation O this time, the navigation system records the array positions. uGym2 KV 00:00:00 1 For children, use High quality. hh:mm:ss mAs Scan quality Navigation * Extra power: Obese No Navigation Collimator Laser Reset timer 60 400 Images Fluoro Single 3D High quality image Scan Ö 30s 400 Images Standard Sub Road DCM Ö30s 200 Images Medium Auto Low dose Dose Metal correction Tech lock 30s 100 Images Mag 0 3p/s Configure Scan Patient System Magnify Motion Relation Collision Check Scan Noise filter Pulse rate 14 * The product names and/or brands referred to are the property of their respective trademark holders. Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 Quick Guide SIEMENS Healthineers For Navigated 3D – When to Choose Navigation/No Navigation When using the C-arm marker for registration (NaviLink3D workflow), set the selection to Navigation Pulse. An ethernet cable connection is Orb. 0º X needed. Ang. 0º Store Select scan quality position 80 Select navigation O Pulse uGym2 KV 00:00:00 1 When using the patient reference with fiducial registration, set the hh:mm:ss mAs Scan quality Navigation selection to No Navigation. No cable connection is needed. Images * Extra power: Obese are transferred to USB. Collimator Laser Reset timer 60 400 Images No Navigation No Navigation Fluoro Single 3D High quality image Scan Ö 30s 400 Images Please note: Standard Sub Road DCM Ö 30s 200 Images For the 3D Scan, as little metal as possible should be in FoV to avoid image quality degradation. When using fiducial registration (No Medium Auto Low dose Dose Metal Navigation on Cios), no metal object may be touching the fiducial Tech lock Ö 30s 100 Images correction markers. Mag 0 3p/s Patient System Magnify Motion Configure Scan Collision Check Scan Noise filter Pulse rate Relation 15 Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023 SIEMENS Healthineers Please note that the learning material is for training purposes only. For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Please note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. © Siemens Healthcare GmbH 2023 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Telephone: +49 9131 84-0 16 siemens-healthineers.com Effective Date: 08 AUG 2023| HOOD05162003363120 Unrestricted © Siemens Healthineers, 2023