Enhancing Standard Operation Procedures to Design SDC Workstations for Cervical Decompression and Spinal Fusion

Cervical spine surgery, particularly for dorsal decompression and fusion in cervical myelopathy treatment, requires precise usage of surgical devices and instruments to achieve an optimal outcome. The surgery aims to decompress the spinal cord by removing any structures compressing the nerves. While open networked central workstations have the potential to increase efficiency and safety, they can face workflow-driven conflicts, such as limited input resources, insufficient screen space for device or patient information, and inadequate control methods. Moreover, current standard operating procedures (SOP) lack detailed information about the inter-device communication requirements. Preventing workflow-driven errors is already addressed in high-risk applications, such as airspace and nuclear power plant control rooms. This paper proposes a method to mitigate workflow-driven conflicts for open networked ISO IEEE 11073 SDC service-oriented device connectivity workstations. By extending clinical SOPs by specific device and instrument usage specifications (eSOP) especially related to human-machine-interaction (HMI) requirements, we could identify potential conflicts in a proposed central OR workstation solution before bringing devices into service. The eSOP has been discussed with spine surgery specialists from the University Hospital RWTH Aachen.