Autonomous lumbar spine pedicle screw planning using machine learning: A validation study.

Autor: Siemionow KB; Department of Research, Holo Surgical Inc, Chicago, IL, USA., Forsthoefel CW; Department of Orthopaedics, University of Illinois, Chicago, IL, USA., Foy MP; Department of Orthopaedics, University of Illinois, Chicago, IL, USA., Gawel D; Department of Research, Holo Surgical Inc, Chicago, IL, USA., Luciano CJ; Department of Research, Holo Surgical Inc, Chicago, IL, USA.
Jazyk: angličtina
Zdroj: Journal of craniovertebral junction & spine [J Craniovertebr Junction Spine] 2021 Jul-Sep; Vol. 12 (3), pp. 223-227. Date of Electronic Publication: 2021 Sep 08.
DOI: 10.4103/jcvjs.jcvjs_94_21
Abstrakt: Introduction: Several techniques for pedicle screw placement have been described including freehand techniques, fluoroscopy assisted, computed tomography (CT) guidance, and robotics. Image-guided surgery offers the potential to combine the benefits of CT guidance without the added radiation. This study investigated the ability of a neural network to place lumbar pedicle screws with the correct length, diameter, and angulation autonomously within radiographs without the need for human involvement.
Materials and Methods: The neural network was trained using a machine learning process. The method combines the previously reported autonomous spine segmentation solution with a landmark localization solution. The pedicle screw placement was evaluated using the Zdichavsky, Ravi, and Gertzbein grading systems.
Results: In total, the program placed 208 pedicle screws between the L1 and S1 spinal levels. Of the 208 placed pedicle screws, 208 (100%) had a Zdichavsky Score 1A, 206 (99.0%) of all screws were Ravi Grade 1, and Gertzbein Grade A indicating no breech. The final two screws (1.0%) had a Ravi score of 2 (<2 mm breech) and a Gertzbein grade of B (<2 mm breech).
Conclusion: The results of this experiment can be combined with an image-guided platform to provide an efficient and highly effective method of placing pedicle screws during spinal stabilization surgery.
Competing Interests: The following authors declare the following financial interests/ personal relationships which may be considered as potential competing interests: Dr. Siemionow – Holosurgical Inc.; Dr. Luciano – Holosurgical Inc.; and Dr. Gawel – Holosurgical Inc.
(Copyright: © 2021 Journal of Craniovertebral Junction and Spine.)
Databáze: MEDLINE