Akron Children's opens $3.5 million OR dedicated to pediatric spine surgeries

Akron Children’s Hospital has opened a dedicated operating room for child, adolescent and young adult spine surgeries, which has, at its centerpiece, the nview s1 navigation system.

As the second children’s hospital in the country and the first in the Midwest to use the nview system, Akron Children’s pediatric orthopedic surgeons now have the benefit of three-dimensional images of the spine in real time in the OR.

“This is a brand-new technology that uses ultralow dose radiation to generate three-dimensional images and artificial intelligence to help us guide our implants into the correct location,” said Dr. Lorena

Floccari, a pediatric orthopedic surgeon and director of spine research at Akron Children’s.

In addition to an estimated 80 percent reduction in the radiation exposure for patients, the system allows surgeons to navigate seeing a true representation of the anatomy.

“We can obtain the images to navigate off of them in one minute compared with 20 minutes using our previous system and they automatically orient in the correct plane of view,” Dr. Floccari added.

The nview labels every vertebra in the spine and, at the end of the surgery, gives the surgeons before and after views with realtime measurements so they can calibrate their correction and make final alignments.

Dr. Todd Ritzman, chair of the Department of Orthopedic Surgery, said the nview will be used as standard of care for idiopathic scoliosis cases, representing about 80 percent of the OR volume.

“The efficiency and ease of this technology fits well into our workflow and we are expecting even better outcomes,” said Dr. Ritzman. “More efficiencies in the OR translate into fewer infections, fewer transfusions, fewer complications, and less cost to the health care system. It’s very exciting to have a facility 100 percent focused on spine surgery.”

The space, formerly a cardiac catheterization lab, is larger than most ORS.

“We have a dedicated pediatric spine team here and this is a dedicated spine OR, built to perform safe and efficient pediatric spine surgeries,” said Dr. Ritzman. “There really isn’t technology that exists that we didn’t put in this room. This is a first in Northeast Ohio.”

Scoliosis, a condition that causes three-dimensional spinal curvature, is diagnosed in up to 4 percent of children, usually between age 10 and adulthood. If the curve is large enough and interventions such as physical therapy and bracing are not effective in slowing the progression, spinal surgery is recommended. Akron Children’s performs nearly 130 surgeries for idiopathic and other types of scoliosis each year.

Dr. Ritzman noted that Akron Children’s spine surgery outcome data is among the best in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) for patient length of stay and with performance better than national benchmarks for factors such as complication rates and re-admissions.

Akron Children’s is committed to pediatric spine research with more than 20 studies currently open and ongoing collaboration with other children’s hospital to share best practices, said Dr. Floccari.

“We are actively recruiting for several scoliosis registries and are involved in multi-center randomized trials for early onset scoliosis and Mehta casting,” she added. “In addition, we have several internal studies where we are reviewing our own care pathways and clinical outcomes.”

The $3.5 million OR project was designed with the clinical team’s involvement with architects and engineers to maximize construction efficiencies using Lean Six Sigma principles.

A donation by Mark and Cathy Clark, of Akron, purchased the nview and supported the spine OR renovation.