Illumination in Spinal Surgery Depending on Different Approaches and Light Sources.

BACKGROUND: Sufficient visualization of the operating field is crucial for success in surgery and is important especially concerning minimally invasive and deep approaches in spine surgery.

METHODS: The spinal microsurgical approach was imitated using an isolated box that was accessed with different devices. Different light sources and auxiliary devices were analyzed and compared. Light sources used were a microscope, a standard operating room lamp, and a headlamp. The auxiliary devices included different tubes with and without optical light fibers, different retractors, and an endoscope.

RESULTS: We demonstrated that different combinations of light sources and auxiliary devices provide significantly different illumination in the artificial operating field. A tube with optical fibers seems to be superior for nonmicroscopic approaches. The smaller these tubes are in diameter, the higher the illuminance on the surgical focus.

CONCLUSIONS: The combination of tube and microscope seems to be the best choice for deep approaches in microsurgical spinal surgery. An endoscope supplies illuminance comparable to a surgical microscope.