NuVasive GE Pulse Lessray User guide

Type
User guide

NuVasive GE Pulse Lessray is a surgical navigation system that enhances the accuracy and efficiency of spine surgeries. It combines real-time imaging with 3D navigation to provide surgeons with a clear view of the surgical site, helping them to place implants with greater precision. The system's advanced features include 2D C-arm stitching for creating panoramic images, low-dose image enhancement for reducing radiation exposure, and the ability to alternate between live and previously captured images for better visualization.

NuVasive GE Pulse Lessray is a surgical navigation system that enhances the accuracy and efficiency of spine surgeries. It combines real-time imaging with 3D navigation to provide surgeons with a clear view of the surgical site, helping them to place implants with greater precision. The system's advanced features include 2D C-arm stitching for creating panoramic images, low-dose image enhancement for reducing radiation exposure, and the ability to alternate between live and previously captured images for better visualization.

GE Pulse Lessray Quickstart Guide
Completed by C-arm tech
This guide is intended to be used for Pulse as a refresher on how to quickly use the Navigation application. For
additional support, please call the Support Hotline: 877.963.8768
Setting up Lessray
Prior to patient entering the room
1. Confirm Pulse is connected to GE via BNC cable and DVI dongle
a) Center BNC port on GE
b) DVI port labeled C-ARM on Pulse
2. Select appropriate GE model from the c-arm dropdown from the SETUP tab on Pulse.
3. Attach the Lessray tablet mount to the c-arm, and the tablet to the mount.
4. Power on the tablet and confirm it automatically connects to the Pulse system.
5. Attach the correct size collar to the c-arm. Attach with the c-arm in rainbow down and the arrow on the collar
pointing up to the ceiling.
For important product safety information please visit nuvasive.com/eIFU
©2022. NuVasive, Inc. or one of its subsidiaries. All rights reserved. The Pulse platform can be used in every procedure; however, not all modalities are cleared for
every procedure. Pulse Navigation is not presently indicated for use in cervical procedures in the EU. 9513707 B
Once the patient is on the table
5. Attach the table array to the bed rail on the c-arm side using the table array clamp and a bed rail adapter (if
necessary). Confirm the side that has the arrays is facing the camera.
a) Note: Suggested to put at the furthest end of the foot or head of bed to be out of the working volume.
Angle straight so the post is perpendicular to the bed.
6. Confirm the camera can see the table array and c-arm array in all positions by selecting the camera icon and
clicking ARRAY VIEW.
C-arm tracking
in Pre-Surgery from Setup LR tab or in Intra-op from Lessray application
1. With the c-arm and table array in view of the camera, take an x-ray image.
2. Adjust the c-arm as necessary using the provided tracking viewfinder and continue taking x-ray images until the
desired image is taken.
3. Press the LEARN button to save the image and location of the c-arm in 3D space. Learned images will appear in
the baseline rows that can be accessed by clicking the right arrow in the bottom left hand corner of
the Lessray screen.
a) Note: If it is the first image taken and LEARNED, you will have to confirm the PHI notification.
4. Continue Learning images as necessary in AP and Lateral until you have all saved.
5. To track back to a Learned image, manipulate the c-arm in all orientations until the three c-arm angle icons are
aligned and outlined in green, and the image is centered in the main viewfinder and the outside line appears
green
Note: to only use c-arm tracking and no advanced image enhancement features of Lessray, simply turn off the
IMAGE ENHANCEMENT toggle from the tool panel.
2D C-arm stitching
1. With the C-arm and table array in view of the camera, take the initial x-ray image of the desired anatomy.
2. Press the x-Ray image STITCH button
For important product safety information please visit nuvasive.com/eIFU
©2022. NuVasive, Inc. or one of its subsidiaries. All rights reserved. The Pulse platform can be used in every procedure; however, not all modalities are cleared for
every procedure. Pulse Navigation is not presently indicated for use in cervical procedures in the EU. 9513707 B
3. Translate the c-arm slightly so the next image has ~¾ overlap over the first image.
a) Note: The viewfinder outside line should still appear green. If it appears yellow, the C-arm has been
translated too far and should be moved back. Only translate in, out, left, right, up, and down. Do not
angle while stitching.
4. Take a new image while the viewfinder is green.
5. Continue translating the c-arm and taking new images until the entire anatomical area has been captured.
6. Select END STITCH to finish and blend the stitch.
Labeling baselines and stitched images
1. After Learning a baseline image or taking a stitched image, click the Live photo in the top right screen.
2. Select the Label button. Drag and drop labels to the corresponding vertebral body.
3. Click Save to save the labeled image to the image bank.
Achieving crisp endplate X-Ray images with angle grid
(Learning AP and Lateral baselines for prone patient)
1. Note: follow this process to take the initial learned AP and Lateral images.
2. Without any learned images, take an AP image of the anatomy of interest.
For important product safety information please visit nuvasive.com/eIFU
©2022. NuVasive, Inc. or one of its subsidiaries. All rights reserved. The Pulse platform can be used in every procedure; however, not all modalities are cleared for
every procedure. Pulse Navigation is not presently indicated for use in cervical procedures in the EU. 9513707 B
2. Press the GRID button.
3. Wag the c-arm using the c-arm base until the superior endplate of the inferior vertebral body is lined up with
the center pink grid line in the viewfinder.
4. Rotate the c-arm down into Lateral, adjust as necessary for height, and take a shot.
5. The resulting image should be a crisp endplate shot in lateral. Suggested to Learn this image for C-arm tracking
back.
6. Using the grid still on the screen, Cant the c-arm until the superior endplate of the inferior vertebral body is
lined up with the grid line.
7. Rotate the c-arm up into AP, adjust as necessary for height and translation, and take a shot.
8. The resulting image should be a crisp endplate shot in AP. Suggested to Learn this image for C-arm tracking
back.
For important product safety information please visit nuvasive.com/eIFU
©2022. NuVasive, Inc. or one of its subsidiaries. All rights reserved. The Pulse platform can be used in every procedure; however, not all modalities are cleared for
every procedure. Pulse Navigation is not presently indicated for use in cervical procedures in the EU. 9513707 B
Low-dose image enhancement with alignment
1. To lower the dose settings on the C-arm with a previously Learned image:
a) GE: press the LOW-DOSE and PULSE button.
2. While keeping the viewfinder outline green, take a new low-dose image of the anatomy.
3. The resulting image should align with the learned standard-dose image which should enhance the low-dose
image.
4. Continue imaging in low-dose whenever the viewfinder is green.
5. To adjust the amount of enhancement, simply move the image enhancement slider.
6. If adjusting the image enhancement slider is not adequate for visibility of metal, try selected the METAL BOOST
button.
Alternating images
1. When an image alternate is desired, confirm the C-arm is in the same location as a previously Learned image
using the c-arm tracking feature and green indicators.
2. Take a shot that aligns with the previously Learned image.
3. Press the ALTERNATE button from the tool panel.
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NuVasive GE Pulse Lessray User guide

Type
User guide

NuVasive GE Pulse Lessray is a surgical navigation system that enhances the accuracy and efficiency of spine surgeries. It combines real-time imaging with 3D navigation to provide surgeons with a clear view of the surgical site, helping them to place implants with greater precision. The system's advanced features include 2D C-arm stitching for creating panoramic images, low-dose image enhancement for reducing radiation exposure, and the ability to alternate between live and previously captured images for better visualization.

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